Amerigroup. An Anthem Company.

Tennessee Providers

Precertification requirements


To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, and then choose Authorizations or Auth/Referral Inquiry, as appropriate.

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Behavioral health

Please submit all precertication requests through our preferred method at Availity.com

If you prefer to paper fax, please submit correct forms to:

Inpatient:

1-877-434-7578

Outpatient:

1-800-505-1193

Services billed with the following revenue codes always require precertification:

0240 to 0249 all-inclusive ancillary psychiatric
0901, 0905 to 0907, 0913, 0917 behavioral health treatment services
0944 to 0945 other therapeutic services
0961 psychiatric professional fees

Pharmacy

Check our Preferred Drug List.

Services billed with the following revenue codes always require precertification:

0632 pharmacy multiple sources

Medicare/long-term services and supports

Medicare

Precertification is not required for physician evaluation and management services for members of the Medicare Advantage Classic plan.

Long-term services and supports

Providers needing an authorization should email us at ltcprovreq@amerigroup.com or call 1-877-440-3738.

Call:

1-877-440-3738

The following always require precertification:

Elective services provided by or arranged at nonparticipating facilities

All services billed with the following revenue codes:

0023 home health prospective payment system
0570 to 0572, 0579 home health aide
0944 to 0945 other therapeutic services
3101 to 3109 adult day and foster care

Email:

ltcprovreq@amerigroup.com

Provider tools & resources

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