Newsletters and Updates
Monthly Provider Digests
August 17, 2026
AmeriHealth Caritas North Carolina Provider Digest August 2026
ACNC Welcomes New Director of Provider Network Management; Your Voice Matters; Let Us Know — Member Intervention Form Now Available in NaviNet; Vendor Transition for Retrospective Review Services; Updated CARE Card Rewards Promote Preventive Care; Earn Incentives While Improving Care Gaps; Market President’s Visit to Asheville; Stop By and See Us at the August Pediatric Society Annual Meeting; Register to Attend the North Carolina Standard Plan Annual Quality Forum Webinar; Understand the Prenatal Immunization Status Measure; Population Health Programs Provide Integrated Care to Members
July 21, 2026
AmeriHealth Caritas North Carolina Provider Digest July 2026
Federal Changes to Medicaid Beginning October 1, 2026; Earn Up to $350 Per Care Gap Closed in Our 2026 Value-Based Programs; Your Feedback Needed on Tobacco Cessation Program Offerings; Regional Baby Showers Resume in August; ACNC Sponsoring the North Carolina Pediatric Society 2026 Annual Meeting; New Resource: Biosimilar Preferred Drug List Updates Webpage; Preferred Drug List Updated in July; New Provider Account Executive Coverage Map; Refer Your Patients to the ACNC Complex Care Management Program; NaviNet® Dispute Letter Access Update; Cervical Cancer Screening (CCS-E) Measure
Provider Guidance and Updates
May 15, 2026
Class 1 Recall: TRUE METRIX Blood Glucose Monitoring Systems (PDF)
April 27, 2026
Provider Network Notification: Claims payment accuracy (PDF)
March 20, 2026
Provider Network Notification: Non-DPU transfers (PDF)
Connections archive
In addition to our monthly provider digests, we publish a Connections provider magazine once each year.
Archive
June 18, 2026
AmeriHealth Caritas North Carolina Provider Digest June 2026
New Value-Based Payment Programs Begin July 1; Community Care Physician Network Annual Clinician Conference Recap; Pharmacy Prior Authorization Guidance; Prior Authorization Reminder: Three Points of Identification Needed for HIPAA Compliance; Controlling Blood Pressure Toolkit: Reducing Disparities In the Management of Hypertension in African American Patients; School Supplies Award Available in July; Collaborating to Enhance Population Health; Immunization for Adolescent (IMA) Combo 2 HEDIS® Measure
May 14, 2026
AmeriHealth Caritas North Carolina Provider Digest May 2026
Claims and Billing Quick Reference Guide; Biosimilar Preferred Drug List Update; North Carolina Obstetrical & Gynecological Society 2026 Annual Meeting Recap; Provider Network Management Team Holds Provider Forum in Raleigh; See You at These Upcoming Spring Conferences; Let Us Know — Member Intervention Request Form Submission Options; NaviNet Appeals Search Functionality Update; ICD-10 Update; Evidence-Based Clinical Guidelines and Utilization Management Criteria; Non-Emergency Medical Transportation; Providing Care for Patients Prescribed Antipsychotic Medications
April 15, 2026
AmeriHealth Caritas North Carolina Provider Digest April 2026
Provider Input Helps Improve Quality of Care for ACNC Members; Tobacco-Free Campus Policy Requirements Postponed Indefinitely; ACNC YouTube Channel Offers Original Patient Education Videos; Preferred Drug List Updated; Patient Assistance Program May Offer Access to Xifaxan and Other Medications; New Medicaid Direct Pharmacy Benefits Administrator; CCPN Annual Clinicians Conference; NC Pediatrics Society Practice Managers’ Retreat; NaviNet Feature Update; Credentialing Reminder; Tips to Meet the Prenatal and Postpartum Care (PPC) HEDIS® Measure; Social Determinants of Health and Low Birth Weight
March 30, 2026
AmeriHealth Caritas North Carolina Provider Digest March 2026
Plan Now for Participation in Our 2026 Value-Based Programs; Medicaid Direct Pharmacy Benefit Manager Change Effective May 2; Registration Is Now Open for 2026 ACNC Provider Support Forums; New Member Benefit — Gym Membership; Expectant Moms and Families Are Welcome at Regional Baby Showers; Circumcision Coverage Guidance; Reminder: CMS Final Rule to Hasten Prior Authorization; Member Rights, Responsibilities and Privacy; Find Us Out and About During Spring Conference Season; Colorectal Cancer Screenings
February 11, 2026
AmeriHealth Caritas North Carolina Provider Digest February 2026
ACNC Partnering With Salisbury Pediatrics for Healthy Eating and Asthma Care Initiative; Save the Date: 2026 ACNC Provider Forums; New On-Demand Content Available to Provider Practices; 2026 Regional Baby Showers for Expectant Moms and Families; i2i Winter Conference Recap; ACNC Eases Administrative Burden With Reductions in Prior Authorization Requirements; Childhood Immunization Coverage Remains the Same in North Carolina; CAHPS Survey and Tips to Improve Patient Experience; Medical Record Data Request for Select Providers; NaviNet Claim Appeals Status Check Update; Providing Care for Patients Recently Discharged from the Emergency Department or Hospital for Substance Use and/or Mental Illness; Smoking Cessation and Minority Populations
January 8, 2026
AmeriHealth Caritas North Carolina Provider Digest January 2026
Medicaid Rates Reversal Updates, Medicaid Readmission Review Updates, New On-Demand Content Available to Provider Practices, New Vendor — Edifecs Clinical Insights (CI) Solution Informational Sessions, Stop by and Say Hello at the i2i Conference, NC Academy of Family Physicians Winter Meeting, Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey, Medical Record Data Request for Select Providers, Vendor Outreach to Providers to Support Risk Adjustment Solutions, Behavioral Health Prior Authorization Updates, Help Us Support Our Members by Sharing Data, NaviNet Disputes Status Enhancement, CMS Interoperability and Prior Authorization Final Rule Update
November 26, 2025
AmeriHealth Caritas North Carolina Provider Digest November 2025
Promoting Vaccine Adherence Among Black and African American Patients; Expecting and New Moms Are Focus of New Benefit Offerings; Pharmacy Benefits During Pregnancy; Vision Benefits for Members; Provider Engagement Is Top Priority; ACNC Disaster Response Featured at NC Public Health Association Conference; Stop by and Say Hello at NC Academy of Family Physicians event!; It’s HEDIS Season: Medical Records Contact Information Needed; Exact Sciences Cologuard Kits Being Sent to Selected Members; Glycemic Status Assessment for Patients With Diabetes; Incentive Available for UST HealthProof Provider Engagement Coordination Program; Avoid Claims Denials: Include Prenatal and Postpartum Care (PPC) F Codes on Claims Submission; Pharmacy Prior Authorization; Discontinuation of Coverage: Xifaxan (Rifaximin); Cell and Gene Therapy Guidance; Expectations for Home Health Electronic Visit Verification Are in Effect; Let Us Know if You Need Help With Specialty Referrals; Post-Appointment Survey Provider Scorecard in NaviNet
October 30, 2025
AmeriHealth Caritas North Carolina Provider Digest October 2025
Incentive Available for UST HealthProof Engagement; Updated Provider Manual Now Available; Pharmacy Updates; Post-Appointment Survey Provider Scorecard in NaviNet; Antibiotics and Acute Bronchitis; Data Exchange Opportunities; FREE CME for ECHO Behavioral Health Bootcamp; Exact Sciences Cologuard Now Available to Members; Expectations for Home Health Electronic Visit Verification; Reminder to Include Prenatal and Postpartum Care (PPC) F Codes on Claims Submission; Prior Authorization Lookup Tool; ACNC Adds Extra Benefits for Members and Infant Car Seat Available for New Moms; Member Intervention Request Form for Specialty Care Referrals; Wellness & Opportunity Center Events in November; Watch Demetrius’ Story About Smoking Cessation, and Share it with Your Patients; Avoid Scams: Can You Spot the Phish?
September 25, 2025
AmeriHealth Caritas North Carolina Provider Digest September 2025
You Are Invited to Lunch With ACNC Leadership; Provider Satisfaction Survey; NEW Vision Services Webpage; Preferred Drug List Update; Primary Care Incentive Increase; ECHO Behavioral Health Bootcamp Returns, Offering FREE CME; Evidence-Based Clinical Guidelines and Utilization Management Criteria; Build a Culture of Prevention Through Early and Periodic Screening, Diagnostic and Treatment Services; Data Exchange Opportunities; Preparing for 2025 – 2026 Influenza Season; Member Rights, Responsibilities and Privacy; Streamlined Provider Website; Hard Launch for Electronic Visit Verification and Home Health Service Providers; and Preventing Fraud, Waste and Abuse
August 28, 2025
AmeriHealth Caritas North Carolina Provider Digest August 2025
NCDHHS Measles Resources Hub; Credentialing Reminder; Provider Satisfaction Survey; Join Us for Lunch and to Learn About Value-Based Care Incentive Programs; Primary Care Incentive Increase; ECHO Behavioral Health Bootcamp Returns, Offering FREE CME; Colorectal Cancer Screening HEDIS® Measure; Nursing Facility Cost of Care Payments Update; Updates to NC Medicaid Payments to Prohibited Entities; NaviNet Improves Efficiency for Provider Operations (CORS); UST HealthProof to Support ACNC Providers; and Transportation Vendor Update
July 28, 2025
AmeriHealth Caritas North Carolina Provider Digest July 2025
Transportation Vendor Update; Suspension of Healthy Opportunities Pilot; Claims Investigations Attachments Now Available Via Navinet; Primary Care Provider Change Request Form Is Live. NCDHHS Updates; Post-Appointment Survey Provider Scorecard Available in NaviNet; NEW! Primary Care Providers Claims Adjustment Reason Code (CARC); and Stakeholder Training Opportunities
July 24, 2025
UST HealthProof to support ACNC providers in closing documentation gaps for members with chronic conditions (PDF)
ACNC has contracted with UST HealthProof (UST) to support providers in collecting complete and accurate member health histories to help facilitate correct billing and clinical insights.
June 26, 2025
AmeriHealth Caritas North Carolina Provider Digest June 2025
Primary Care Provider Change Request Form Is Live; Measles, Mumps and Rubella Vaccine Rates Low Amid Outbreaks; NCDHHS Releases Care Management Rate Bulletin; Healthy Opportunities Pilot Update; Skilled Nursing Facility Eligibility; Home Health Electronic Visit Verification Required as of October 1; Preferred Drug List (PDL) Updates; Reminder on NC Medicaid Pharmacy Copayment Requirements; Tip for Submitting Delivery Notifications Correctly; Clinical Leadership Forums Continue in July; Regional Baby Showers Celebrate Moms and Help Achieve Quality Goals; Member Quit for Life Info Session
May 23, 2025
AmeriHealth Caritas North Carolina Provider Digest May 2025
Successful Behavioral Health Bootcamp Series Returning in the Fall; Multiple ACNC Behavioral Health Resources Are Available; Share Your Clinical Feedback; Quality Corner: Controlling High Blood Pressure; 2025 Clinical Leadership Forums Begin in June; Your Claims. Paid Right. The First Time.; Institutional Ambulance Emergency Services Reminder; Personal Care Services Billing and Reimbursement Policy Update; Prior Authorizations Time-Saving Tips; CARE Card Rewards Promote Preventive Care; Member Newsletters; Primary Care Providers Are Invited for a No-Cost CME and CEU Opportunity; Need to Connect With Us?
April 25, 2025
AmeriHealth Caritas North Carolina Provider Digest April 2025
Learn About Value-Based Care Reimbursement; Share Your Clinical Feedback; Depression Screening and Follow-Up for Adolescents and Adults (CDF); Processing Prior Authorizations — Tip for Unit Submission; Personal Care Services (PCS) Billing and Reimbursement Policy Update; New Webpage for Home Health Care Services (HHCS) With Electronic Visit Verification (EVV) Process; Offering Members Access to No-Cost Language Interpretation Services; FREE CEUs for Online Psychological First Aid Training; Grant Opportunity for Collaborative Care Management (CoCM)
March 20, 2025
AmeriHealth Caritas North Carolina Provider Digest March 2025
Deadline for Providers Offering Home Health Care Services (HHCS) With Electronic Visit Verification (EVV) Process; Grant Opportunity for Collaborative Care Management; Clinical Champions and Operational Leads Are Invited to the ACNC Clinical Leadership Forums; Best Practices for Providing Care for Patients Recently Discharged From the Emergency Department or Hospital for Substance Use Disorder and/or Mental Illness; Reminder: Appointment Wait-Time Standards; Your Claims. Paid Right. The First Time; Security Improvements to NaviNet Provider Portal; Consumer Assessment of Healthcare Providers and Systems (CAHPS); Regional Baby Showers for Expectant Moms and Families; ACNC Eases Administrative Burden and Improves Member Access With Reductions in Prior Authorization Requirements; Restoration of Optum/Change Healthcare Connectivity
February 19, 2025
AmeriHealth Caritas North Carolina Provider Digest February 2025
ACNC Eases Administrative Burden and Improves Member Access With Reductions in Prior Authorization Requirements; Childhood Immunization (CIS) Combo 10 HEDIS Measure; Medical Record Data Request for Select Providers; Let Us know Program Referrals; Claims and Billing Manual Updated; Restoration of Optum/Change Healthcare Connectivity; Encourage Your Patients to Quit Tobacco Products; Tobacco Cessation News; Join Us for Lunch in Fayetteville, Region 5
February 13, 2025
Reductions in Prior Authorization Requirements for Behavioral Health Providers (PDF)
To further our goal of mental health parity, notifications are no longer required for behavioral health codes and have been relaxed for more than a dozen services including, but not limited to, facility-based crisis treatment for children and adolescents, mobile crisis management, and outpatient treatments.
February 13, 2025
Reductions in Prior Authorization Requirements for Providers (PDF)
As part of our ongoing commitment to members and providers, ACNC has eliminated prior authorization requirements for more than 1,900 physical and behavioral health procedure codes since 2023.
January 27, 2025
AmeriHealth Caritas North Carolina Provider Digest January 2025
Recognizing Highest Earning Independent Practices in Our Network; Join Us for Lunch in Greensboro, Region 2; FREE Behavioral Health Boot Camp with CME Credits; Prenatal and Postpartum Care (PPC) F Codes and Warn Edits; Medical Record Data Request for Select Providers; Issue 3 of Connections Is Now Available; Value-based Programs Include Medicaid Expansion Members; Can You Spot the Phish?; and more.
December 19, 2024
AmeriHealth Caritas North Carolina Provider Digest December 2024
Provider Support and Stabilization Following Hurricane Helene; Save the Date for Lunch with Us in Greensboro; Issue 3 of Connections Is Now Available; Value-based Programs Include Medicaid Expansion Members; Providing Care for Patients Prescribed Antipsychotic Medications; Medical Record Data Request for Select Providers; Transportation for ACNC Members; Plan Privacy and Security Procedures Reminder; Telehealth Claims. Paid Right. The First Time; and Quarterly Webinar Series for Behavioral Health Providers.
December 17, 2024
Issue 3 of Connections Now Available (PDF) Opens a new window
Inside you will find articles and interviews promoting cultural competency, best practices for improving perinatal care, and helpful tips for keeping your provider profile current in NCTracks. See if your practice is listed in the article highlighting top provider care-gap closure results. Also, find resources on our Bright Start® program and our member Wellness and Opportunity Centers offering multiple meet-and-greet opportunities with our team. If you would like a printed copy of the 2024 magazine as a resource, please send your request along with mailing address information to your Provider Network Management Account Executive.
November 27, 2024
AmeriHealth Caritas North Carolina Provider Digest November 2024
ACNC Mobile Wellness and Opportunity Center Responds to Disaster Needs; November Is National Diabetes Month; Supporting Definitions for Orthotics, Prosthetics and Supplies; and the 2024 Provider Satisfaction Survey
October 24, 2024
AmeriHealth Caritas North Carolina Provider Digest October 2024
NC Medicaid Temporary Flexibilities Due to Hurricane Helene; Prior Authorization Lookup Tool Now References the NC Medicaid Fee Schedule; Updated Provider Manual; NC Medicaid Reimbursement Rates Increased for Substance Use Treatment; Controlling High Blood Pressure (CBP); Claims and Billing Reminders and Inquiries; Key COVID-19 Changes, New Member Intervention Request Form; Breathe Easy NC: Professional Development Series; Provider Education and more.
September 30, 2024
AmeriHealth Caritas North Carolina Provider Digest September 2024
Updated Provider Manual Now Available; 2024/2025 Season Alert: Respiratory Syncytial Virus (RSV) and Vaccination Information; 2024 Provider Satisfaction Survey; Members Are Sharing Post-Appointment Feedback with Providers; Enroll Now in AmeriHealth Caritas Next; Strategies to Increase Influenza Vaccinations; Regional Baby Showers; Electronic 275 Document Submission — New Availity Functionality; How to Find a Claims Recovery Report; NC Medicaid Adds Coverage for Obesity Management Medications; FREE Member and Family NARCAN Trainings Available at the Asheville Wellness & Opportunity Center; New Quarterly Webinar Series for Behavioral Health Providers; Additional Trainings and more.
August 21, 2024
AmeriHealth Caritas North Carolina Provider Digest August 2024
Value-Added Benefits to Support Prenatal and Postpartum Care; Invitation to Improve HEDIS and Gap Closure for Well-Child Visits and Child/Adolescent Immunizations; Register for Ask the Experts: About Black Maternal Health; Enroll Now in AmeriHealth Caritas Next; Prenatal and Postpartum Care F Codes; New NaviNet Functionality to Support Request for Information; Reminder: Manual/Direct Entry Claims Submission Through PCH Global Is NO Cost to Providers; Avoid Denials When Completing Sterilization and Hysterectomy Consent Forms; No More Copay for Drugs Used to Treat Opioid Use Disorder and Nicotine Replacement Therapy; ACNC to Accept Pharmacy Electronic Prior Authorizations (ePA) Requests; Member Rights, Responsibilities and Privacy; Offering Culturally and Linguistically Appropriate Services (CLAS); Regional Baby Shower Dates Announced; Clinical Leadership Forums; Trainings and more.
July 17, 2024
AmeriHealth Caritas North Carolina Provider Digest July 2024
Ask the Experts: About Black Maternal Health; ACNC to Accept Pharmacy Electronic Prior Authorization (ePA) Requests; Exemption of Copay for Drugs Used to Treat Opioid Use Disorder and Nicotine Replacement Therapy; DELAY: Tobacco-Related Policy Requirements Go into Effect on July 1, 2025; Safeguarding Your Practice: Beware of Phishing Scams; Prenatal and Postpartum Care (PPC) HEDIS Measure; Value-Added Benefits to Support Prenatal and Postpartum Care; Regional Baby Showers; Known Systems Issues Reminder; Member Rights, Responsibilities, and Privacy; Invitation to Improve HEDIS and Gap Closure for Well-Child Visits and Child/Adolescent Immunizations; Support in Navigating Electronic Visit Verification (EVV), and Tobacco Treatment in Adolescent and Young Adult Populations.
June 25, 2024
AmeriHealth Caritas North Carolina Provider Digest June 2024
2024 PerformPlus® True Care — Maternity Care Providers Incentive Program; Workshops to Support HEDIS and Gap Closure for Well-Child Visits and Child/Adolescent Immunizations; ACNC to Accept Pharmacy Electronic Prior Authorizations (ePA); Early and Periodic Screening, Diagnostic and Treatment Wellness Visits Do NOT Require Prior Authorization; Regional Baby Showers; Members Earn $25 for Completing a Care Needs Screening; ACNC Upcoming Pharmacy Changes; Prior Authorizations; Remittance Advice Payment Recovery Details Now Available; Tobacco-Related Policy Requirements Go into Effect on July 1, 2024; ACNC Trainings and Forums.
May 22, 2024
AmeriHealth Caritas North Carolina Provider Digest May 2024
Mental Health Provider Resources; Remittance Advice Payment Recovery Details Now Available; Virtual Self-Care and Burnout Prevention Workshop for Providers; Depression Screening and Follow-Up for Adolescents and Adults (CDF); Upcoming ACNC Baby Shower Events; Screening for Mental Health or Substance Use Disorder Service Available; Behavioral Health Medications Reminder; Behavioral Health Benefits Webpage; Personal Care Service (PCS) Provider: How to Avoid Claim Denials for Overnight Shifts; No Outpatient Behavioral Health Prior Authorizations Limitations; Tobacco-Related Policy Requirements Go into Effect on July 1, 2024; Substance Use Disorder Services Are Part of the Standard Plan Service Array; Post-Appointment Survey Provider Scorecard Available in NaviNet; Support in Navigating Electronic Visit Verification; Intensive Behavioral Health Approaches to Tobacco Treatment; Foundations of Client-Centered Tobacco Treatment: A Training for Maternal Health Providers; ACNC Trainings and Forums.
May 17, 2024
Improvements to Home Health Care Services (HHCS) Electronic Visit Verification (EVV) Process (PDF)
Opens a new windowAmeriHealth Caritas North Carolina (ACNC) and other prepaid health plans have worked together with the EVV vendor HHAeXchange (HHAX) to increase automation and ease the burden of documenting a visit electronically. Our collective goal is to increase efficiency and decrease process confusion. These new efficiencies deployed on May 15, 2024, and are not expected to require any changes from our home health providers.
April 17, 2024
AmeriHealth Caritas North Carolina Provider Digest April 2024
Virtual Self-Care and Burnout Prevention Workshop for Providers; Introducing Dr. Price, Behavioral Health Medical Director; Chlamydia Screening in Women (CHL) HEDIS Measure; Regional Baby Showers; NC Medicaid Pharmacy Copayment Requirements Reminder; Vision Services for Adults; Substance Use Disorder Services Are Part of the Standard Plan Service Array; Post-Appointment Survey Provider Scorecard Available in NaviNet; Use the Correct Payer ID When Filing Claims; Prior Authorization Reminder; Rapid Response Outreach Team and Screenings; Change for Life: Tobacco-Free Recovery NC Meeting; Trainings and Forums.
March 20, 2024
Additional Information on Electronic Claims Submission to Availity (PDF)
Opens a new windowWhile Change Healthcare continues to address their network interruption related to a cyber security incident, AmeriHealth Caritas North Carolina (ACNC) has established a connection with Availity to receive electronic claims. In order to submit electronic claims to ACNC you must register with Availity.
March 20, 2024
AmeriHealth Caritas North Carolina Provider Digest March 2024
Prior Authorization Reminder; Quality Corner Featuring Glycemic Status Assessment for Patients with Diabetes; Navigating Electronic Visit Verification, Crosswalks and More; Use the Correct Payer ID when Filing Claims; Pharmacy News; No-cost Non-emergency Transportation for ACNC Members; Trainings and Forums.
March 8, 2024
Alternative Claim Submission Option Available (PDF)
Opens a new windowChange Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. In the interim, AmeriHealth Caritas North Carolina has established an alternative solution for providers to submit claims via direct claims entry.
March 5, 2024
Change Healthcare System Interruption (PDF)
Opens a new windowChange Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident.
February 21, 2024
AmeriHealth Caritas North Carolina Provider Digest February 2024
2024 PerformPlus® True Care Program Training Session; Updated Provider Manual Now Available; Quality Corner featuring Behavioral Health Provider Focus: Critical Incident Reporting, Medical Record Data Request for Select Providers and Regional Baby Shower news; North Carolina Tobacco Cessation News; Claims and Billing Guidance for Home Health Electronic Visit Verification; Upcoming Pharmacy Changes and Discontinuation of Medications; How to Link Patients to Healthy Opportunities Pilot Services; Provider Orientation Training; Electronic Funds Transfer Enrollment Link and 2024 Clinical Leadership Forums.
January 17, 2024
AmeriHealth Caritas North Carolina Provider Digest January 2024
Updated Provider Manual Now Available, 2024 PerformPlus® True Care Programs Launch, Prior Authorization Requirement Changes for Select Procedures, Childhood Immunization (CIS) Combo 10 HEDIS® Measure, Regional Baby Showers Continue in 2024, Pharmacy Updates and Drug Discontinuations, Tips to Prevent Claims Denials, Members Earn $25 for Completing a Care Needs Screening, Provider Trainings and more.