NaviNet Provider Portal

What is NaviNet?

NaviNet is an easy-to-use, no-cost to providers, secure portal that links providers to AmeriHealth Caritas North Carolina. NaviNet helps speed up the provider-health plan connection and can often replace paper transactions. If you're not a NaviNet user, learn more about NaviNet.

Access real-time clinical Healthcare Effectiveness Data and Information Set (HEDIS) alerts, claims information and updates, drug authorizations, and more. The Medical Authorizations portal (for requests, inquiries, and submission) is accessed through the NaviNet homepage, located in the Workflows menu.

Providers are invited to attend a featured training offered monthly called, Registering for and Using NaviNet.

Resources and reports

• Admit report (including roll up)
• Authorization status summary
• Care manager report
• Claims status summary (including roll up)
• Discharge report (including roll up)
• Disenrollment reports
  • Guide to accessing disenrollment reports on NaviNet PDF
• Drug authorizations
• Known system issues tracker PDF
• Member clinical summary
• Member eligibility
• NaviNet resources
  • Document Exchange ADT Alerts PDF
  • Medical Authorizations Participant Guide PDF
  • Medical Authorizations FAQ PDF
  • NaviNet Medical Authorizations Workflow Training PDF
  • Prior Authorization Inquiry Process Tutorial Video
  • Prior Authorization Submission Process Tutorial Video
• Panel rosters (including roll up)
• Prior authorizations