Training resources
For physicians and healthcare professionals
ELEARNING
Provider Pathways
Provider Pathways is a 24/7 educational resource that offers a foundation for doing business with Amerigroup Community Care in Tennessee. It is designed to be user friendly and gives you flexibility when scheduling training for yourself and your staff. To launch the Provider Pathways eLearning, you must first complete a short registration survey .
MANUALS & GUIDES
Provider manual
The provider manual provides key administrative information, including the quality improvement program, the Utilization Management program, quality standards for participation, claims appeals, and reimbursement and administration policies for Medicaid and Medicare recipients.
Fraud, waste, and abuse (FWA)
The Tennessee Bureau of Investigation Medicaid Fraud Control Division (TBI MFCD) is the state agency responsible for the investigation of provider fraud, waste, and abuse in the TennCare program. Amerigroup and its network providers are required to cooperate with all state and federal agencies, including TBI MFCD and OIG, in investigating or prosecuting FWA.
Providers can find more information on preventing, detecting, and reporting FWA by referring to section 19 or page 172 of your Medicaid provider manual. For Medicare, providers can find this information in sections 5 (page 36) and 21 (page 153).
Trainings and tutorials
Amerigroup offers training and tutorials to support providers in continuing their education. Presentations, videos, and other training documentation will be added as they become available.
- Certification of Mandatory False Claims Act Education Compliance
- Compliance Information (Fraud Card)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) Overview
- DSNP Overview Training
- Certification of Mandatory False Claims Act Education Compliance
- Guide to register for and access the Provider Online Reporting application
- Home Health and private duty nursing updates-2020 Provider info expo
- Information About 2020 Special Needs Plans
- Medicaid – Interactive Care Reviewer (ICR) FAQ
- Medicare Advantage - Interactive Care Reviewer (ICR) FAQ
- Medicare Advantage - Medicare Risk Adjustment Provider Documentation and Coding Guide
- Medicare Advantage - Understanding Medicare Advantage wellness visits
- Medication Precertification Tutorial
- Member Information and Panel Listing
- NEMT Learning Management System Guide
- Nursing Facility Provider Diversion Training
- Patient360 User Guide Training
- Phase 2 IDD Integration Training Deck
- Precertification Request Tutorial
- Precertification Status and Appeals Tutorial
- Provider Initiated Notice Presentation
- Provider Online Reporting (POR) Guide
- Provider updates to account information
- TennCare school nursing guidelines
- The mental health practitioner hub
Training opportunities for behavioral health providers
Sign up with Psych Hub, our new training partner for our behavioral health providers. You’ll gain access to Psych Hub’s catalog of educational podcasts, videos, and other accredited content. You’ll also gain the opportunity to receive free continuing education units, a requirement for most professional licenses. Numerous self-paced courses in evidence-based interventions are ready for you. Build your Psych Hub dashboard today.
Additional provider training resources
CMS Toolkit - Telehealth for Providers: What You Need to Know
Related topics
SBIRT
Screening, brief intervention, and referral to treatment
SBIRT is a clinician’s tool for identifying unhealthy substance use behaviors and providing appropriate intervention for at risk patients.
CONTINUING MEDICAL EDUCATION
Improving the patient experience
A series of online courses for providers and office staff that conveys practical strategies for implementing patient care and applying best practices.
RESOURCE LIBRARY
Our full library of provider materials
Having trouble finding the resource you are looking for? Check out our full library of provider materials to locate exactly what you are trying to find.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Policies, guidelines & manuals
- Referrals
- Forms
- Training academy
- Pharmacy information
- Electronic data interchange (EDI)