We are committed to supporting you in providing quality care and services to the members in our network. Here, you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to our members.
Provider forms are located in our online library for easy access.
Amerigroup Community Care offers training and tutorials to support providers in continuing their education. We will add presentations, videos and other training documentation as they become available.
Amerigroup provider manuals and guides provide key administrative information, including quality improvement and utilization management programs, quality standards for participation, claims appeals, and reimbursement and administration policies.
Amerigroup makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures and referrals to validate medical necessity.
Many of the tools you need — such as eligibility and benefits inquiries, claims submission or status inquiries, and prior authorizations — can now be accessed by logging into your account on the Availity Portal.
The Healthcare Effectiveness Data and Information Set (HEDISĀ®)
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).