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.
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.
- Clinical Practice Guidelines Matrix
- Clinical Utilization Management Guidelines
- Asthma Clinical Practice Guideline
- Asthma Action Plan
- Attention Deficit Hyperactivity Disorder Clinical Practice Guideline
- Attention Deficit Hyperactivity Disorder (ADHD) Care Process Overview
- August 2020 Clinical Utilization Management (UM) Guidelines
- Diabetes Mellitus Clinical Practice Guideline
- Therapy for Children's Disabilities Medical Policy
- Preventive Health Care Guidelines
- STATE Medical Necessity Criteria for Acute Treatment