Newsletters and Updates
Provider updates
April 17, 2024
AmeriHealth Caritas North Carolina Provider Digest April 2024
Virtual Self-Care and Burnout Prevention Workshop for Providers; Introducing Dr. Price, Behavioral Health Medical Director; Chlamydia Screening in Women (CHL) HEDIS Measure; Regional Baby Showers; NC Medicaid Pharmacy Copayment Requirements Reminder; Vision Services for Adults; Substance Use Disorder Services Are Part of the Standard Plan Service Array; Post-Appointment Survey Provider Scorecard Available in NaviNet; Use the Correct Payer ID When Filing Claims; Prior Authorization Reminder; Rapid Response Outreach Team and Screenings; Change for Life: Tobacco-Free Recovery NC Meeting; Trainings and Forums.
March 20, 2024
Additional Information on Electronic Claims Submission to Availity (PDF)
While Change Healthcare continues to address their network interruption related to a cyber security incident, AmeriHealth Caritas North Carolina (ACNC) has established a connection with Availity to receive electronic claims. In order to submit electronic claims to ACNC you must register with Availity.
March 20, 2024
AmeriHealth Caritas North Carolina Provider Digest March 2024
Prior Authorization Reminder; Quality Corner Featuring Glycemic Status Assessment for Patients with Diabetes; Navigating Electronic Visit Verification, Crosswalks and More; Use the Correct Payer ID when Filing Claims; Pharmacy News; No-cost Non-emergency Transportation for ACNC Members; Trainings and Forums.
March 8, 2024
Alternative Claim Submission Option Available (PDF)
Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. In the interim, AmeriHealth Caritas North Carolina has established an alternative solution for providers to submit claims via direct claims entry.
March 5, 2024
Change Healthcare System Interruption (PDF)
Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident.
February 21, 2024
AmeriHealth Caritas North Carolina Provider Digest February 2024
2024 PerformPlus® True Care Program Training Session; Updated Provider Manual Now Available; Quality Corner featuring Behavioral Health Provider Focus: Critical Incident Reporting, Medical Record Data Request for Select Providers and Regional Baby Shower news; North Carolina Tobacco Cessation News; Claims and Billing Guidance for Home Health Electronic Visit Verification; Upcoming Pharmacy Changes and Discontinuation of Medications; How to Link Patients to Healthy Opportunities Pilot Services; Provider Orientation Training; Electronic Funds Transfer Enrollment Link and 2024 Clinical Leadership Forums.
January 17, 2024
AmeriHealth Caritas North Carolina Provider Digest January 2024
Updated Provider Manual Now Available, 2024 PerformPlus® True Care Programs Launch, Prior Authorization Requirement Changes for Select Procedures, Childhood Immunization (CIS) Combo 10 HEDIS® Measure, Regional Baby Showers Continue in 2024, Pharmacy Updates and Drug Discontinuations, Tips to Prevent Claims Denials, Members Earn $25 for Completing a Care Needs Screening, Provider Trainings and more.
December 19, 2023
AmeriHealth Caritas North Carolina Provider Digest December 2023
2024 PerformPlus® True Care Programs Launch, NaviNet Plan Central Homepage Has a Fresh Look, Prior Authorization Updates, NC Medicaid News, Policy Updates, Billing Guidance for High-Density Lipoprotein (HDL) or Lipid Testing, Stop Claims Denials and Receive Faster Payment, Electric Non-medical Breast Pumps Are Available for Expectant or New Moms, NEW Electronic Funds Transfer Enrollment Link, Trainings and Forums Continue into 2024 and more.
December 4, 2023
Issue 2 of Connections is now available (PDF)
Inside you will find interviews and articles promoting HEDIS measures and value-based programs; quality improvement initiatives; and helpful provider resources such as Provider Reverification instructions, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and training registration for NaviNet, our provider portal. We also highlight our Wellness and Opportunity Centers and activities. If you would like a printed copy, please send your request along with mailing address information to acncprovidercommunications@amerihealthcaritasnc.com.
November 17, 2023
AmeriHealth Caritas North Carolina Provider Digest November 2023
AmeriHealth Caritas North Carolina to Manage Prior Authorization Requests Now Managed Through eviCore Healthcare; New Private Duty Nursing and Personal Care Service Medicaid Rates Increased; Providers Required to Resubmit Claims with Missing Revenue Codes; Rendering Provider Information Required for Claims; Sexually Transmitted Infection Treatment Policy Change; 2023 NC Community Health Worker Summit; NC Medicaid Expansion Policy Flexibilities Announced; Care Gap Response Form and Documentation Deadlines; Provider Reverification and more.
October 28, 2023
AmeriHealth Caritas North Carolina Provider Digest October 2023
NC Medicaid Expansion Policy Flexibilities Announced, Flu Shot Reward for Infants/Toddlers, No Co-Pay Required for Adult Vaccine Administration, Care Gap Closure Documentation Reminder, 2023 Provider Satisfaction Survey, Timely Filing Requirement Announcement, Member CARE Card Rewards Program, Childhood Health and Wellness Clinical Leadership Forum and additional trainings.
September 28, 2023
AmeriHealth Caritas North Carolina Provider Digest September 2023
NC Medicaid Expansion Will Launch on December 1, 2023; Pitt County Area Community Baby Shower & Maternity Fair; New Mobile Wellness & Opportunity Center; Preferred Drug List Release; Timely Filing Requirement Announcement; Provider Reverification; No-cost Non-emergency Transportation for ACNC Members; Support to Become Tobacco-Free; Monthly or On-Demand Trainings and more.
August 24, 2023
AmeriHealth Caritas North Carolina Provider Digest August 2023
Triad Community Baby Shower Invitation: Greensboro Wellness & Opportunity Center Event; Physical Health and Chronic Conditions: ACNC Clinical Leadership Forum; Meet Our Provider Network Management Leadership; Deadline and Extension Reminders; How to Save up to 16 minutes Submitting Prior Authorizations, Training Opportunities; Member Benefits Spotlight and more.
July 27, 2023
AmeriHealth Caritas North Carolina Provider Digest July 2023
NC Medicaid Reminder: Provider Reverification Resumes, Home Health Care Service Providers – Claim Reimbursement Change Effective October 1, Registration is now open for the 3rd Annual Virtual Statewide Quality Forum, 2023 AmeriHealth Caritas North Carolina Clinical Leadership Forums, Nursing Services for Sexually Transmitted Infection Treatment Prior Authorization Clarification, Reminder: Follow State Guidelines When Submitting 340B Claims for Payment, Tobacco Cessation Resources and Trainings with CEUs, and more.
June 30, 2023
AmeriHealth Caritas North Carolina Provider Digest June 2023
Help Patients with Medicaid Recertification; Behavioral Health Clinical Coverage Policy Update; Electronic Visit Verification Mandatory for Home Health Services Providers on July 1; Tobacco Cessation Counseling Services Available to All Members; and more.
June 30, 2023
Upgrade of the EDI claims compliance to Strategic National Implementation Process (SNIP) Level 4, effective August 1 (PDF) Opens a new window
As of August 1, any claims not in compliance with SNIP Level 4 will be rejected and will not make it through the claim adjudication process.
June 30, 2023
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Information and On-demand Training (PDF) Opens a new window
EPSDT training invitation, request to attest and FAQs.
June 16, 2023
Nursing Services for Sexually Transmitted Infection Treatment Prior Authorization Clarification (PDF) Opens a new window
ACNC does not require Prior Authorizations for T1002 when billed with sexually transmitted infection (STI) Diagnosis codes.
June 14, 2023
Reminder: Follow State Guidelines When Submitting 340B Claims for Payment (PDF) Opens a new window
Review the September 3, 2019, NCDHHS Bulletin Opens a new window for additional procedure information.
May 22, 2023
AmeriHealth Caritas North Carolina Provider Digest May 2023
Electronic Visit Verification Mandatory for Home Health Services Providers on July 1; NC Medicaid Temporary Emergency Flexibilities Ending; Electronic Funds Transfer through Change Healthcare is FREE; June 14, 2023, Women’s Health and Wellness Clinical Leadership Forum; Provider Manual 2022 Clarifications; and more
May 22, 2023
Invitation to Women’s Health and Wellness Clinical Leadership Forum (PDF) Opens a new window
Second quarter forum held on June 14, 2023
April 19, 2023
AmeriHealth Caritas North Carolina Provider Digest April 2023
Ending Clinical Policy Flexibilities Associated with the Federal Public Health Emergency, NC Medicaid Electronic Visit Verification Now Active for Home Health Care Services Providers, Change Healthcare (ConnectCenter™) New User Guide Links, End of Public Health Emergency (PHE) – Help Patients with Redetermination, Tailored Plan launch delayed until October 1, 2023, and more
April 14, 2023
Specialty Provider Training Sessions Offered by eviCore Healthcare (PDF)Opens a new windoweviCore to conduct a series of trainings based on specialty/service type
March 30, 2023
ACNC Announces Benefit Management Services Collaboration with eviCore Healthcare (PDF). Opens a new window
eviCore to manage prior authorization for selected health care services
March 28, 2023
NC Health Choice (North Carolina’s CHIP program) Is Moving to Medicaid.
NC Health Choice members move to Medicaid April 1, 2023
March 27, 2023
NC DHHS Notice: Electronic Visit Verification (EVV) Stakeholder Meeting (PDF) Opens a new window
Invitation to register for meeting held on March 28, 2023
March 17, 2023
ACNC Training Notice: Quality Enhancement Programs (PDF) Opens a new window
Invitation to register for value-based program trainings in March 2023
March 16, 2023
AmeriHealth Caritas North Carolina Provider Digest March 2023
Tailored Plan Launch Delayed, Medicaid Redetermination Process to Resume in April, NC Health Choice to Medicaid: Claims and Billing, Updated Preferred Drug List Release: April 1, 2023, Connecting with your New Account Executive, New and Ongoing Training and more
February 22, 2023
AmeriHealth Caritas North Carolina Provider Digest February 2023
Public Health Emergency Update, Provider Total Cost of Care (TCOC) and Quality Enhancement Programs (QEP) Launch, 2023 Clinical Leadership Forums, NC Health Choice (North Carolina’s CHIP program) is moving to Medicaid and more
February 8, 2023
Personal Care Service and Electronic Visit Verification Providers to Manage Diagnosis Codes in the HHAeXchange Provider Portal (PDF) Opens a new window
New billing and rate guidance for PCS and EVV providers
January 24, 2023
AmeriHealth Caritas North Carolina Provider Digest January 2023
NC Health Choice (North Carolina’s CHIP program) is moving to Medicaid, North Carolina Medicaid Standard Plan and Tailored Plan Tobacco-Free Policy Requirements, Reminder: Appointment wait-time standards, Vision Services for Adults and more
December 2, 2022
AmeriHealth Caritas North Carolina Provider Digest December 2022
Impacting Prenatal Care in North Carolina, North Carolina Incident Response Improvement System (NC IRIS) — Tips for Users, Reminder: Appointment Wait Time Standards, Medical Record Data Request and more
November 30, 2022
AmeriHealth Caritas North Carolina Provider Digest November 2022
Partnering with Providers to Impact Diabetes in North Carolina, Close Care Gaps by Mid-December, Paper Claims Submission Error Resolved, Childhood Health and Wellness Clinical Leadership Forum and more
November 17, 2022
CONNECTIONS and a Clinical Leadership Forum (PDF)
Durable Medical Equipment (DME) Billing Guidance (PDF)
November 11, 2022
Prospective Claims Payment Review Threshold Update (PDF)
November 7, 2022
Electronic Visit Verification (EVV) Reminder for Home Health Care Service (HHCS) Providers (PDF)
October 31, 2022
AmeriHealth Caritas North Carolina Provider Digest October 2022 (PDF)
Topics in this issue: NaviNet and helpful provider resources, Updated Provider Manual now available, 2022 Provider Satisfaction Survey, NEW virtual EPSDT orientation
September 30, 2022
AmeriHealth Caritas North Carolina Provider Notice: Medicaid temporary flexibilities due to Hurricane Ian (PDF)
September 29, 2022
NCDHHS Delays Medicaid Managed Care Tailored Plans (PDF)
September 20, 2022
AmeriHealth Caritas North Carolina Provider Digest September 2022 (PDF)
Topics in this issue: 2022 Provider Satisfaction Survey, EPSDT and Oral Health Periodicity Schedule, NaviNet resources, DEI Training, Introduction to Market President
August 1, 2022
AmeriHealth Caritas North Carolina Provider Digest August 2022 (PDF)
Topics in this issue: Claims payment review process, Updated provider material, Trauma informed care provider resources, COVID incentive update, DE&I training
July 20, 2022
AmeriHealth Caritas North Carolina Provider Digest July 2022 (PDF)
Topics in this issue: Medicaid Managed Care One-Year Anniversary, Encourage your Patients to Quit Tobacco Products, New and Updated Provider Resources, EPSDT Reminder, COVID-19 Report and Reminders, Introduction to Director of Quality Improvement
July 1, 2022
AmeriHealth Caritas North Carolina Provider Notice re: 275 Claim Attachment Functionality (PDF)
June 24, 2022
AmeriHealth Caritas North Carolina Provider Digest June 2022 (PDF)
Topics in this issue: Prior Authorizations Clarification, Medicaid Co-Payments Increase, Provider Reverification, Behavioral Health Fee Schedule Updated, 9-8-8 Suicide Prevention Lifeline Number, Smoking Cessation Trainings, Introduction to Director of Practice Transformation
May 19, 2022
AmeriHealth Caritas North Carolina Provider Digest May 2022 (PDF)
Topics in this issue: Options for Pharmacy Prior Authorizations, COVID-19 report and reminders, Self-Paced DE&I Training, Introduction to Behavioral Health Medical Director.
April 20, 2022
AmeriHealth Caritas North Carolina Provider Digest April 2022 (PDF)
Topics in this issue: Coverage updates, Prospective Claims Payment Review Process, Pharmacy news, NaviNet Resources, Healthy Opportunities Pilot program, New Population Health Director.
March 30, 2022
AmeriHealth Caritas North Carolina Provider Digest March 2022 (PDF)
Topics in this issue: EFT enrollment, Pharmacy Prior Authorizations, Preferred Drug List Updates, COVID Vaccination Eligibility and Overdue Report, New Provider Network Management Director.
March 23, 2022
NCDHHS Bulletin: Medicaid for Pregnant Beneficiaries Extended to 12 Months After Birth
March 21, 2022
NCDHHS Bulletin: Extension of NC State of Emergency Temporary Flexibilities
February 18, 2022
AmeriHealth Caritas North Carolina Provider Digest February 2022 (PDF)
Topics in this issue: Claims Submission alert, New Online Training Available, Trauma-informed Care Education Series.
January 10, 2022
NCDHHS Bulletin: NC Medicaid Omicron COVID-19 Surge: Update on vaccines and providing ongoing flexibilities
November 23, 2021
AmeriHealth Caritas North Carolina Provider Digest November 2021 (PDF)
Topics in this issue: COVID-19 Vaccination Incentive, Group Level Disenrollment Reports, Prior Authorizations, EFT Payments.
September 21, 2021
NCDHHS Bulletin: Keep NCTracks Records Current to Avoid Claims Processing Issues
September 13, 2021
AmeriHealth Caritas North Carolina Provider Digest September 2021 (PDF)
September 1, 2021
NCDHHS Bulletin: Temporary Provisions for COVID Surge: Post-Acute PA Exceptions and Hospital at Home Program
August 13, 2021
AmeriHealth Caritas North Carolina Provider Digest August 2021 (PDF)
Topics in this issue: Prior Authorization – Specialized Therapies, Clinical Policies, Claims and Billing Guide Update and EFT enrollment reminder.
July 14, 2021
AmeriHealth Caritas North Carolina Provider Digest July 2021 (PDF)
July 14, 2021
Behavioral Health Fee Schedule Update (PDF)
July 2, 2021
Inpatient Discharge Planning Needs (PDF)
June 30, 2021
Member ID Card Changes and Panel Roster Updates (PDF)
June 29, 2021
NCDHHS Bulletin: Children’s Developmental Services Agency Providers Carved Out of Managed Care
June 25, 2021
About our Adult Vision Value Added Service (PDF)
June 16, 2021
Let's Get Started (EFT Sign-up, Jiva Training and Events) (PDF)
April 30, 2021
Ancillary Services Provider Agreement Modification Notice (PDF)