NaviNet
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 NaviNet
Log in or register to get started with NaviNet:
Reports
- Admit report (including roll up)
- Authorization status summary
- Care manager report
- Care gap information, reports, and requests
- Claims status summary (including roll up)
- Discharge report (including roll up)
- Disenrollment reports
- Drug authorizations
- Healthcare Effectiveness Data and Information Set (HEDIS®) improvement campaign query
- Known system issues tracker PDF
- Member clinical summary
- Member eligibility
- Panel rosters (including roll up)
- Prior Authorizations
Healthcare Effectiveness Data and Information Set (HEDIS)
Participating primary care providers can access and resolve Healthcare Effectiveness Data and Information Set (HEDIS) Care Gaps for AmeriHealth Caritas North Carolina members via NaviNet.
Care Gaps identify missing recommended preventive care services so that you may address them when your patient comes in for an office visit. Care Gaps are based on HEDIS measures and may impact your quality scores.
Once you've logged in to NaviNet, check the Activity tab to see alerts for Care Gaps that need your response. Alternatively, you can click on Patient Clinical Documents under Workflows to see the list of members who have Care Gaps. You will also see Care Gaps for your patients upon using the Eligibility and Benefits Inquiry and on the Member Clinical Summary and Care Gap Query Report.