Providers
If you are not already a provider in our network, please review the Join our Network webpage for contracting details.
Provider checklist
As an ACNC provider, you should:
- Assure your Medicaid Credentialing is up to date with NC DHHS
- Connect with your dedicated Account Executive (AE)
- Sign up for Electronic Funds Transfer (EFT)
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Register for and use Navinet, our provider portal
- Download the Provider Quick Reference Guide (PDF)
- Learn about our ACNext (Exchange) health plans
- Review our Provider Manuals, Policies and Forms
- Know about Extra Benefits for Members
- Be familiar with member transportation services
- Support members’ language and cultural preferences
Connections Provider Magazine
We publish a digital and printed provider magazine once a year. Contact your AE for a hard copy and read the latest digital edition.
Your voice matters
Share your clinical feedback
We encourage providers to offer expertise to evaluate the effectiveness of our Quality Assessment Performance Improvement (QAPI) program and share insights regarding clinical initiatives by participating in virtual committee meetings hosted by AmeriHealth Caritas North Carolina (ACNC) medical leadership.
Providers are compensated for their time and participation. Please email our Quality team to volunteer, if you have questions.
The Quality Assessment Performance Improvement Committee (QAPIC) meets every other month for two hours and oversees ACNC efforts to measure, manage and improve high-quality member outcomes.
The Provider Clinical Oversight Workgroup (PCOW) meets for one hour each month and is responsible for monitoring ACNC strategies and metrics to provide input and guidance on the health plan’s improvement efforts, including reviewing new/updated clinical policies and providing feedback. This workgroup reports to the QAPIC.
Medicaid Credentialing
To receive a contract from ACNC, you must first be credentialed with North Carolina's Department of Health and Human Services (NCDHSS). They have a centralized, one-stop provider enrollment application and credentialing process to reduce the provider's administrative burden of becoming an in-network provider. For more information regarding enrollment, providers can call the NCTracks call center at 1-800-688-6696, fax 1-855-710-1965 or email NCTracksProvider@nctracks.com.
Re-credentialing is sometimes referred to as re-verification or re-validation. These words are used interchangeably. This process is required every five years. As part of this process, the provider’s credentials and qualifications will be evaluated to ensure they meet requirements to participate in the NC Medicaid program. The re-verification process also includes a criminal background check on all owners and managing relationships associated with this provider record.
Providers will receive a notification via their NCTracks secure portal Provider Message Inbox when they are scheduled to begin the re-verification process.