Claims Submissions and Disputes

If you disagree with the outcome of a claim, you may begin the Amerigroup Community Care grievance and appeal provider payment dispute process. The simplest way to define a claim payment dispute is when the claim is finalized, but you disagree with the outcome.

Amerigroup uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. Use Availity to submit claims, check the status of all your claims, appeal a claim decision and much more.

Don’t have an Availity account?

Finding claims tools on Availity

Submit claims

  1. From the Availity home page, choose Claims & Payments from the top navigation.
  2. Select Type of claim from the drop-down menu.

Claims status inquiry

  1. From the Availity home page, select Claims & Payments from the top navigation.
  2. Select Claim Status Inquiry from the drop-down menu.

Claims dispute

To check claims status or dispute a claim:

  1. From the Availity home page, select Claims & Payments from the top navigation.
  2. Select Claim Status Inquiry from the drop-down menu.
  3. Submit an inquiry and review the Claims Status Detail page.
  4. If the claim is denied or final, there will be an option to dispute the claim. Select Dispute the Claim to begin the process. You’ll be redirected to the payer site to complete the submission.

Clear Claims Connection

To use Clear Claims Connection:

  1. From the Availity home page, select Payer Spaces from the top navigation.
  2. Select the health plan.
  3. From the Payer Spaces home page, select the Applications tab.
  4. Select the Clear Claims Connection tile.

Related information

For a complete guide to the Provider Claim Payment Dispute Process, please refer to the provider manual.

Provider tools & resources

Interested in becoming a provider in the Amerigroup network?

We look forward to working with you to provide quality services to our members.