Policies, guidelines and manuals
Amerigroup District of Columbia, Inc. is committed to supporting you in providing quality care and services to the enrollees in our network. Here, you will find information for assessing coverage options, guidelines for clinical utilization management (UM), practice policies, and support for delivering benefits to our enrollees.
Provider manual and quick reference cards
The Amerigroup provider manual provides key administrative information, including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies.
Medical policies and clinical UM guidelines
Medical policies address the medical necessity of new services or procedures and new applications of existing services or procedures. Clinical UM Guidelines focus on detailed selection criteria, goal length of stay, and location for generally accepted technologies or services.
Related information
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)