Our case managers help make healthcare easier and less overwhelming for our members. They work with our members to help them understand the types of services we offer to them and how to participate in their own care.
Your patients may already be working with one of our case managers. If not, or if they need help contacting their case manager, please have them call Member Services.
Our case managers may call our members if:
- They or you, their healthcare provider, thinks case management might help the member.
- They have just gotten out of the hospital and need help with follow-up visits to other doctors.
- They are going to the emergency room (ER), often for non-urgent care that could be handled by you, their healthcare provider.
- They call our 24-hour Nurse HelpLine and need more follow-up for ongoing care.
- They have serious physical problems and need more help managing their health.
- They have behavioral health problems and need more help working with all of their doctors.
Case managers can also help with:
- Setting up healthcare services for the member.
- Checking a member’s plan of care.
- Addressing Social Determinants of Health.
- Assisting with Community Resources.
From time to time, members may have questions about calls they receive from one of our case managers. When we call, a nurse or social worker will:
- Always identify themselves with their name, title, and position with Amerigroup.
- Tell the member about the services we offer.
- Talk to the member about their health and how they’re handling different parts of their life.
If the member is not available, no medical information is shared on the voicemail, only the CM’s name and a return number.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)