News and Updates

Connections provider newsletters

Read the latest issue of

Provider alerts

May 29, 2025
Practitioner credentialing rights (PDF)
May 28, 2025
Formulary updates (July 15, 2025) (PDF)
May 23, 2025
Reminder to direct members to AmeriHealth Caritas Next participating labs (PDF)
May 20, 2025
Save the date — claims overpayment response process (PDF)
May 19, 2025
Balance or surprise billing reminders (PDF)
May 14, 2025
Participating provider office standards for access and availability (PDF)
May 5, 2025
Tips to avoid timely filing and other common claim denials (PDF)
May 1, 2025
Stelara biosimilar medications (PDF)
April 29, 2025
Blood Pressure Communication Program (PDF)
April 16, 2025
GLP-1 medications (PDF)
April 14, 2025
Provider self-service through NaviNet (April update) (PDF)
April 07, 2025
Provider data information form (PDIF) (PDF)
March 18, 2025
Electronic pharmacy prior authorization (PDF)
March 11, 2025
Formulary updates (April 15, 2025) (PDF)
March 4, 2025
Guidance to use the correct payer ID (PDF)
February 18, 2025
Exchange risk adjustment overview and documentation guidance (PDF)
February 17, 2025
Balance or surprise billing reminders for AmeriHealth Caritas Next members (PDF)
February 14, 2025
Additional weekly payments added (PDF)
February 3, 2025
Tips to avoid timely filing and other common claim denials (PDF)
January 22, 2025
Ways to avoid common errors in electronic prior authorization submissions (PDF)
January 14, 2025
HEDIS advance notice of Reveleer (PDF)
January 13, 2025
Provider self-service through NaviNet (PDF)
January 6, 2025
Provider Data Information Form (PDIF) January 2025 update (PDF)

Provider Alerts Archive

December 20, 2024
275 claim attachment transactions update (PDF)
December 12, 2024
Participating provider office standards for access and availability (PDF)
December 4, 2024
Return to normal business operations post-Hurricane Helene (PDF)
December 3, 2024
2025 PerformPlus® Gaps in Care Closure Program (PDF)
December 3, 2024
Use the correct payer ID when filing claims (December reminder) (PDF)
November 26, 2024
Formulary update (January 1, 2025) (PDF)
November 21, 2024
Restoration of Optum/Change Healthcare connectivity (PDF)
October 28, 2024
Introduction to Optum’s “Prospective Inpatient Claim Review” and “Credit Balance Review” programs (PDF)
October 25, 2024
Provider Manual revisions (January 2025) (PDF)
October 24, 2024
Provider information security awareness (PDF)
October 24, 2024
Reminder: Use of modifiers for physical, occupational, and speech therapy and physical rehabilitation (PDF)
October 15, 2024
CPT CAT II code incentive program (PDF)
October 11, 2024
Provider satisfaction survey reminder (PDF)
October 7, 2024
Attestation requirement: Provider Data Information Form (PDF)
October 4, 2024
PerformPlus® Gaps in Care Closure Program (PDF)
October 2, 2024
Pfizer voluntarily withdraws all lots of sickle cell disease treatment Oxbryta® (voxelotor) from worldwide markets (PDF)
September 16, 2024
Kidney and eye health evaluation for patients with diabetes (PDF)
September 11, 2024
Population Health program/coordination of medical care (PDF)
September 9, 2024
275 claim attachment transaction is now available via Availity (PDF)
September 6, 2024
Reminder to use the Provider Appeal Form available on our website (PDF)
September 5, 2024
Formulary update (November 1, 2024) (PDF)
September 3, 2024
Reminder to use the correct payer ID when filing claims (PDF)
August 22, 2024
Lab test billing reminder (PDF)
August 16, 2024
Provider manual revisions (August 2024) (PDF)
August 13, 2024
Balance or surprise billing reminders for North Carolina Next members (PDF)
July 29, 2024
Exchange Risk Adjustment Overview and Documentation Guidance (PDF)
July 26, 2024
Change Healthcare ConnectCenter™ Update (PDF)
July 15, 2024
Prior Authorization Requirement Changes (PDF)
July 3, 2024
Formulary update (August 1, 2024) (PDF)
July 1, 2024
Provider Data Information Form (PDIF) (PDF)
June 12, 2024
Reminder to Use the Correct Payer ID When Filing Claims (PDF)
June 7, 2024
Reminder to Direct Members to AmeriHealth Caritas Next Participating Labs (PDF)
May 31, 2024
No-Cost Smoking Cessation Therapy (PDF)
May 16, 2024
Remittance Advice Payment Recovery Details Now Available! (PDF)
May 3, 2024
Change Healthcare Restoration of Services Status (PDF)
April 19, 2024
Breast Cancer Screening of Women With Schizophrenia — An Opportunity for Improvement (PDF)
April 15, 2024
National Imaging Associates is becoming Evolent (PDF)
April 12, 2024
Provider Data Information Form (PDF)
April 9, 2024
Prior Authorization Guidelines Tip Sheet: ADHD Medications (PDF)
April 5, 2024
Formulary update (May 1, 2024) (PDF)
March 25, 2024
Claims Timely Filing Deadline Extension (PDF)
March 25, 2024
Electronic Remittance Advice (ERA/835) Access (PDF)
March 21, 2024
Additional Information on Electronic Claims Submission to Availity (PDF)
March 8, 2024
Claim Submission Options Update (PDF)
March 6, 2024
Alternative Claim Submission Option Available (PDF)
March 4, 2024
Change Healthcare System Interruption – Update (PDF)
February 12, 2024
Healthcare Effectiveness Data and Information Set (HEDIS®) (PDF)
January 3, 2024
Use the correct plan payer ID when filing claims (PDF)
December 6, 2023
Formulary update (January 1, 2024) (PDF)
November 30, 2023
Prior authorization requirement changes for select procedure/HCPCS codes (PDF)
November 28, 2023
Lab test billing reminder (PDF)
November 3, 2023
Provider satisfaction survey reminder (PDF)
November 3, 2023
PerformPlus® Gaps in Care Closure program (PDF)
October 12, 2023
Prior authorization request reminder (PDF)
October 9, 2023
Use of AT modifier for chiropractic care (PDF)
September 26, 2023
Formulary update (September and October 2023) (PDF)
August 17, 2023
Formulary update (September 5, 2023) (PDF)
August 4, 2023
Submission of electronic documentation (275 Transactions) (PDF)
August 1, 2023
Updated practitioner credentialing rights (PDF)
July 26, 2023
Use of modifiers for physical, occupational, and speech therapy, and physical rehab (PDF)
July 26, 2023
Use of modifiers for chiropractic care (PDF)
July 25, 2023
Care Gaps that can be closed in NaviNet (PDF)
July 18, 2023
Provider Data Information Form (PDIF) attestation instructions (PDF)
July 17, 2023
Pharmacy Formulary Changes (August 1, 2023) (PDF)
June 26, 2023
EDI claims compliance upgrade to SNIP level 4, effective July 20, 2023 (PDF)
May 9, 2023
Akorn issues voluntary nationwide recall of various human and animal drug products within expiry due to company shutdown (PDF)
April 20, 2023
FDA Commissioner and Chief Scientist announce decision to withdraw approval of Makena (PDF)
April 15, 2023
Pharmacy formulary update (PDF) (May 15, 2023)
January 1, 2023
Pharmacy formulary update (PDF) (January 1, 2023)
For Providers