Provider Manuals, Policies and Guidelines
Amerigroup Community Care is committed to supporting you in providing quality care and services to the members in our network. Here you will find the Amerigroup provider manuals, guidelines for clinical Utilization Management (UM), medical policies and coding spotlights for common conditions.
Provider Manuals and Quick Reference Guides
The Amerigroup provider manuals provide key administrative information, details regarding programs that include the utilization management program and case management programs, quality standards for provider participation, guidelines for claims and appeals, and more.
- Georgia Provider Manual
- HEDIS Desktop Reference Guide 2024
- HEDIS Coding Booklet 2024
- Individual Network HMO –Commercial Business Provider Manual
- Planning for Healthy Babies® Provider Manual Addendum
- Provider Manual Behavioral Health Addendum
- Community Behavioral Health Provider Manual
- Georgia Medicaid Provider Quick Reference Card
- DentaQuest of Georgia Quick Reference Guide
- Centers of Medical Excellence Transplant Operations Manual
- HEDIS Desktop Reference Guide 2023
- Provider Digital Engagement Supplement
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.
- May 2024 Clinical Utilization Management Guidelines
- November 2023 Clinical Utilization Management Criteria
- August 2023 Clinical Utilization Management Guidelines
- Clinical Utilization Management Criteria May 2023
- February 2023 Clinical Utilization Management Criteria
- November 2022 Clinical Utilization Management Guidelines
- August 2022 Clinical Utilization Management Guidelines
- February 2022 Clinical Utilization Management (UM) Guidelines
- November 2021 Clinical Utilization Management (UM) Guidelines
- May 2021 Clinical Utilization Management (UM) Guidelines
- August 2021 Clinical Utilization Management (UM) Guidelines
- February 2021 Clinical Utilization Management (UM) Guidelines
- November 2020 Clinical Utilization Management (UM) Guidelines
- 2024 Clinical Practice Guidelines
- Clinical Utilization Management Guidelines
- August 2020 Clinical Utilization Management (UM) Guidelines
- Therapy for Children's Disabilities Medical Policy
- Preventive Health Care Guidelines
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Reimbursement Policies
- Provider Manuals, Policies & Guidelines
- Referrals
- Provider Training Academy
- Forms
- Pharmacy Information
- Georgia Families 360°℠