Provider Digest
Provider Digest — October 2022
AmeriHealth Caritas North Carolina (ACNC) is committed to providing the support you deserve. You will find the following topics in this email:
NaviNet and helpful provider resources
NaviNet is an easy-to-use, no-cost, secure provider portal that links your practice to ACNC. You can track authorizations and claims status, but NaviNet also provides you with access to:
- Administrative reports
- File a grievance or appeal
- Multiple clinical reports
- Panel rosters
- NEW Tools for Quality Outcomes
File provider grievance and appeals
Filing provider grievances and appeals can now be accomplished via NaviNet. See the Forms and Dashboards link under Workflows on the left-hand side of the NaviNet homepage.
Then, select the path you need for either a grievance or appeal.
Find out more about NaviNet and register here or reach out to your dedicated Provider Network Account Executive.
Updated Provider Manual Now Available
The updated Provider Manual is available on our website. Several high-level revisions include:
- Updated language to reflect current business practices
- Updated time and distance, and definition charts per NCDHHS
- High dollar post-payment reviews process
- 275 claims attachment process
- Where to find the Known Systems Issues tracker
- Contact information for different departments
For your convenience, a Revision Log is posted along with the Provider Manual to help identify updates.
Our Claims and Billing Manual (PDF) has also recently been updated. It contains new ZZ Qualifier provider taxonomy language, high dollar pre-payment and post-payment reviews information and 275 medical attachments process additions.
2022 Provider Satisfaction Survey
We want to hear from you! This fall, we'll be reaching out to a sample of our provider practices with a Satisfaction Survey to help us gain insight into how we are doing. The survey will take about 15 minutes to complete. Results from the survey will be used to guide administrative and operational changes to our health plan and point out areas that might need improvement.
If you receive the welcome letter and survey in the mail, there are two ways to complete the survey:
- Online, using the credentials given in the letter, by going to www.sphsurvey.com.
- Complete the enclosed survey and return it using the pre-paid envelope.
Thank you for your continued partnership with ACNC in the service of our members, and for your critical role in providing and coordinating care for them.
TRAINING
New Early Periodic Screening, Diagnostic and Treatment (EPSDT) Virtual Training
Join presenter, Yalanda Thomas, an EPSDT Manager with AmeriHealth Caritas Family of Companies who will orient attendees on the Oral Health Periodicity Schedule, patient screening visits, referral requirements and more.
Register for December 8, 2022, from Noon to 1 p.m. ET. and attend this informative presentation or visit our Featured Trainings page for more information.
Understanding and Enrolling in Electronic Funds Transfer (EFT) Training
If you have not already registered for electronic funds transfer (EFT) payments, we have simplified the process with the addition of a downloadable registration form. To learn more, sign up for Understanding and Enrolling in EFT Training held November 8, 2022 or December 6, 2022 from Noon to 1 p.m. ET. The training will help you find the form, along with a step-by-step guide under EFT on the Claims and Billing page of our website.
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