Amerigroup. An Anthem Company.

Iowa Providers

Welcome, providers!

Here you will find resources that help healthcare professionals do what they do best — care for our members.

At Amerigroup Iowa, Inc., we value your partnership as a provider in our network. That's why we’ve redesigned the provider site to make it more useful for you and easier to use.

Interested in joining our provider network? We look forward to working with you to provide quality services to our members.

COVID-19 information

Amerigroup is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Availity access

The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.

At Availity, you can:

Request authorizations
Submit claims
Confirm eligibility

Receive email from Amerigroup

Amerigroup is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.

Critical incident reporting

Amerigroup has a critical incident reporting and management system for incidents that occur in a home- and community-based long-term care services and supports delivery setting. As a participating Amerigroup provider, you’re required to participate in critical incident reporting.

Provider news and updates

Get the latest articles and announcements on Amerigroup policies, clinical/utilization management guideline updates, state and federal regulatory changes, and much more.

Medicaid updates

Early elective delivery new claim edit process

Beginning June 27, 2022, your health plan will be implementing a new early elective delivery (EED) claim submission process, which will capture non-medically necessary EEDs and, at the same time, distinguish uncomplicated spontaneous labor/vaginal deliveries at 37 to 38 weeks’ gestation.

Reminder – Place of service code for professional services in an outpatient setting

We require all services that are rendered in an office, professional building, medical office building, clinic, or a space owned by a hospital or an institutional provider, other than the primary structure on the campus of the hospital or institutional provider, to be billed on a CMS-1500 Claim form. When billing for these professional services on a CMS 1500, they should be billed with place of service (POS) 19 or 22, not POS 11 or 12.

Non-Medicare recognized therapists — billing for dual members

Amerigroup Iowa, Inc. wishes to update and remind our behavioral health (BH) provider network of the importance of including the rendering therapist detail on the CMS-1500 Claims Form when submitting for a member who is dually enrolled with Medicare and Medicaid.

Register today: Exploring the intersection of race and disability

Amerigroup is committed to making healthcare simpler and reducing health disparities. Open discussion about the disability experience for people of color and reducing implicit bias for those in healthcare is critical to improving the health and well-being of the communities in which we live and serve — all Americans.

Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines

Effective for dates of service on and after September 11,2022, the following updates will apply to the AIM Specialty Health (AIM®) Musculoskeletal Clinical Appropriateness Guidelines. As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable healthcare services.

Medicare updates

Medicare Advantage - Non-Medicare recognized therapists — billing for dual members

Amerigroup Iowa, Inc. wishes to update and remind our behavioral health (BH) provider network of the importance of including the rendering therapist detail on the CMS-1500 Claims Form when submitting for a member who is dually enrolled with Medicare and Medicaid.

Medicare Advantage - MCG Care Guidelines 25th Edition

Effective September 1, 2021, Amerigroup will upgrade to the 25th edition of MCG* care guidelines for the following modules: inpatient and surgical care (ISC), general recovery care (GRC), chronic care (CC), recovery facility care (RFC), and behavioral health care (BHC).

Featured resources

Pharmacy information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Maternal child program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

Behavioral health

We work collaboratively with hospitals, group practices and independent behavioral healthcare providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

NCQA Health Plan Recognition

Accredited NCQA Health Plan

Provider tools & resources

Interested in becoming a provider in the Amerigroup network?

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