Getting Started

Claims submission

  • The AmeriHealth Caritas North Carolina EDI Payer ID number is 81671.
  • AmeriHealth Caritas North Carolina does not require your practice or facility to enroll with Change Healthcare to submit EDI claims. Electronic claim submissions to AmeriHealth Caritas North Carolina will follow the same process as other electronic commercial submissions.
  • Your Provider ID for submitting claims or receiving electronic funds transfer (EFT) payments is your NPI number.
  • Learn more about electronic claims submissions.

Payment

  • EFT allows providers to receive payments directly in the bank account of their choice. When enrolled in EFT, providers will automatically receive electronic remittance advices for those payments. To enroll, contact ECHO Healthcare at 1-888-834-3511, Monday to Friday, between 8 a.m. to 6 p.m. ET, or visit https://enrollments.echohealthinc.com/efteradirect/enroll.

Claims payment schedule

  • Medical payment cycles run every Monday and Wednesday.
  • Pharmacy payment cycles run every four days.

NaviNet allows easy access to member eligibility verification, claims submission and status, claims investigation, prior authorization submission and access to member panel rosters for primary care providers included under your contract. NaviNet is an easy-to-use, no-cost, web-based solution that links participating providers to AmeriHealth Caritas North Carolina and offers tools for patient health management. NaviNet helps speed up the provider-health plan connection and can often replace paper transactions.

  • If you are already a NaviNet user for your other health plans, AmeriHealth Caritas North Carolina will be automatically added to your account.
  • If you are not a NaviNet user, you will be able to register for NaviNet. Visit NaviNet's website to sign up. You will need your Federal Tax ID number. Make sure to complete all information requested.

If you need more information or assistance, call NaviNet at 1-888-482-8057 or AmeriHealth Caritas North Carolina Provider Services at 1-888-738-0004.

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