Recursos para proveedores

Ambetter Health brinda las herramientas y el apoyo que necesita para ofrecer atención de la mejor calidad.

NEW! Ambetter of North Carolina Provider Insights Webinar Series

Join Ambetter of North Carolina Provider Insights beginning September 22 at 12:00 PM ET, our quarterly provider education program designed to keep providers informed with timely clinical education, provider resources, and important Ambetter of North Carolina updates. Each session will feature a guest speaker sharing expertise on a relevant healthcare topic, followed by timely Ambetter of North Carolina updates, provider resources, and important reminders.

To learn more and register for the session, including information about the featured speaker and webinar topic, please visit the registration page here.

Reference Materials

New Provider Orientation

Claims and Claims Payment

Practitioner Enrollment and Provider Demographic Updates

Requests to join our network are not processed using these forms. To request to join our network, please use our Network Participation Request Form. Once you have completed this form, please allow up to five business days days for a member of our team to contact you.
To add a new facility to an existing application or to submit location changes, please download and fill out the Ambetter Facility Roster Template (Excel | .xlsm) and submit these forms along with all credentialing documentation to AmbetterNCProviderDirectoryRequest@CENTENE.COM.
To add a new practitioner to your practice, please download and fill out the Ambetter Practitioner Roster Template (Excel | .xlsm) and submit these forms along with all credentialing documentation to AmbetterNCProviderDirectoryRequest@CENTENE.COM.

Health Equity Toolkit

Quality Improvement

Risk Adjustment

Medical Management

Quality

Notification of Pregnancy Provider Report

Other

CMS Interoperability & Prior Authorization Final Rule: CY2025 Prior Authorization Requirements Reports and Metrics Summaries

In accordance with the Centers for Medicare & Medicaid Services (CMS) Final Rule (CMS 0057 F), we are annually publishing our prior authorization requirements and performance metrics to promote transparency, accountability, and better support our members and providers.

Reports:

The data presented in these publications reflects prior authorization requests processed during the applicable measurement year in accordance with CMS reporting specifications. Metrics are calculated using CMS defined methodologies and may not be directly comparable to alternative reports or third party summaries.