Patient care overview
We have collected resources to support care for members in our network. Here, you will find behavioral health services, maternal child services, health education resources, and condition care program support.
Maternal child services
When it comes to our pregnant enrollees, we’re committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our Taking Care of Baby and Me® program, which is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
As part of the Taking Care of Baby and Me® program, enrollees are also offered the My Advocate® program. This program provides pregnant and postpartum women proactive, culturally appropriate outreach and education through interactive voice response (IVR). Eligible enrollees receive regular phone calls with tailored content from a voice personality (Mary Beth), or they may choose to access the program via a smartphone application or website.
Condition Care
Our Condition Care program is based on a system of coordinated care management interventions and communications designed to assist physicians and other providers in managing enrollees with chronic conditions.
Health education
We advocate a community approach to health education and outreach activities and have a proven record of collaborating with community and faith-based organizations, advocacy groups, and other community resources.
Early and periodic screening, diagnostic and treatment
Amerigroup District of Columbia, Inc. is committed to ensuring enrollees receive age-appropriate, preventive health services. A list of panel enrollees who, based on our claims data, may not have received EPSDT services according to schedule is sent to primary care physicians (PCPs) each month.
Provider tools & resources
- Log in to Availity Essentials
- Launch provider learning hub
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Provider Search Tool
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)