Provider newsletter message: Pharmacy 90 Day Prescription
Reminder: The TennCare pharmacy program allows for a 90-day supply to be dispensed due to COVID-19. Amerigroup Community Care wants to ensure that our members have uninterrupted access to medications during the COVID-19 threat. Temporary procedures have been deployed by TennCare to ensure that the members continue to receive their medications in this time of crisis.
Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
The following updates will apply to the AIM Specialty Health* Clinical Appropriateness Guidelines for Radiation Oncology for claims with dates of service on and after March 14, 2021. Please note that there are no restrictive changes in this update.
Specialty Pharmacy Prior Authorization Updates
Effective for dates of service on and after January 1, 2021, the following specialty pharmacy codes from current or new clinical criteria documents will be included in our precertification review process.
CoverKids transition FAQ (Effective January 1, 2021)
Now available: frequently asked questions with information regarding the CoverKids transition. CoverKids is effective January 1, 2021.
Essential/Everyday Extras is a Medicare Advantage benefit in which the member can choose from a list of optional services to tailor their plan to best suit their needs.
Updated claims submission requirements for Adult Day Center benefit
Effective January 1, 2021, claims submission requirements for day care services provided under Medicare supplemental benefits for Amerigroup for the Adult Day Center benefit in AZ, IA, NJ, TN and TX are as outlined in this document.
Personal Home Helper FAQ
Personal Home Helper provides in-home support for caregiver respite, home-based chores and activities of daily living (ADL) to address needs while recovering from injury or illness. It covers up to four hours per day for up to 62 days or 248 hours of care in a calendar year.
Medicare Advantage — Provider Chat Flier
You now have a new option to have questions answered quickly and easily. With Amerigroup Chat, providers can have a real-time, online discussion through a new digital service, available through Payer Spaces on Availity.