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.
Register for NaviNet
NaviNet provides a quick and streamlined registration process using our digital documentation system for automated identity and business verification. When registering for NaviNet, please have the following information ready to be entered into the online registration form:
- Office name
- Address
- Phone number
- TIN
You will also be asked to attach one of the following documents for verification:
- Certificate of Good Standing
- Sole Proprietor SS-4
- IRS 147C Letter
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
- Drug authorizations
- Known system issues tracker PDF
- Member clinical summary
- Member eligibility
- NaviNet resources
- Claims Investigation Submission Guide PDF
- 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