NaviNet

What is NaviNet?

NaviNet is an easy-to-use, no-cost to providers, secure portal that links providers to AmeriHealth Caritas North Carolina.

Access NaviNet

Log in or register to get started with NaviNet:

Sign up for NaviNet

Log in to NaviNet

Through NaviNet, you can access and submit:

Administrative reports

  • Panel rosters
  • Panel rosters — rolled up
  • Authorization status summary
  • Claims status summary
  • Claims status summary — rolled up

Clinical reports

  • Admit report
  • Admit report — rolled up
  • Care manager report
  • Care gap query
  • Care gap query — rolled up
  • Discharge report
  • Discharge report — rolled up
  • HEDIS® improvement campaign query
  • Member alert standalone care gap request
  • Missing and overdue care gaps request
  • Missing and overdue care gaps adolescent only
  • Missing and overdue care gaps adult only
  • Missing and overdue care gaps all members
  • Missing and overdue care gaps pediatric only
  • Single service care gap query
  • Member clinical summary

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.

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.