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
- Planning for Healthy Babies® Provider Manual Addendum
- Georgia Medicaid 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 Telehealth Coding Bulletin 2022
- HEDIS CAT II Coding Bulletin 2022
- HEDIS Coding Booklet 2023
- HEDIS Desktop Reference Guide 2023
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.
- 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
- 2022 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
- STATE Medical Necessity Criteria for Acute Treatment
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°℠