Protecting our members todays, and their tomorrows, together.
Claims submission alert:
Please note that there are two different AmeriHealth Caritas plans operating in North Carolina. To enable prompt payment, please be careful to charge your claims to the correct health plan by using the correct payer ID when you submit your claims. Please consult the table below for the appropriate plan payer ID. Improper claim submission could result in denied claims and payment delays.
|Plan name||AmeriHealth Caritas North Carolina||AmeriHealth Caritas Next|
|Plan type||Medicaid and North Carolina Health Choice||Individual and family health plans offered both on and off the Exchange|
|Plan payer ID||81671||83148|
AmeriHealth Caritas Next is excited to help you deliver high-quality care to our members. Thank you for choosing us!
When you work with us, you benefit from years of valuable health care experience, knowledge, and a provider service team whose job is to make your job easier.
We work to keep all of our providers up-to-date and informed with the latest plan information and news.
Latest provider news and updates
Access information to help you:
- Join our provider network.
Learn how you can join our dedicated network of providers.
- Access provider training.
Learn how to access our secure provider portal, submit electronic claims, select payment options, and much more.
- Find a provider, pharmacy, or drug.
Use our directories and other online tools to find providers and pharmacies in our network, as well as drugs in our formulary.
- Access the Provider Manual.
Get pertinent policies, procedures, and administrative functions relevant to your practice.
- Access the Claims and Billing Manual (PDF).
Use this guide to help avoid common claim errors and delays in the processing of your claims.
- Read the Provider Reference Guide (PDF).
Have important contact information and resources at your fingertips.
- View the Provider Network Account Executives territory map (PDF).
Find the correct account executive to contact with your provider inquiry.
- Learn about claims, billing, and payment.
Find resources you need to help manage your submission of claims and receipt of payments.
- Get information on prior authorizations.
Get tools and support for submitting prior authorization requests.
- Get forms and documents.
Discover reference materials to help you when caring for our members.
- Access tools and services.
Get access to online tools like NaviNet and Jiva.
- Report fraud, waste, and abuse.
Learn how you can help AmeriHealth Caritas Next monitor and report fraud, waste, and abuse.
If you have any questions, call AmeriHealth Caritas Next Provider Services at 1-855-266-0219.