Apple Health (Medicaid) Provider manuals and guides
Amerigroup Washington, Inc. is committed to supporting you in providing quality care and services to the members in our network. Here you will find information for assessing coverage options, guidelines for clinical Utilization Management (UM), practice policies and support for delivering benefits to our members.
Provider manuals and Quick Reference Cards
Amerigroup provider Apple Health (Medicaid) manuals and Quick Reference Cards provide key administrative information, including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies.
- Provider Digital Engagement Supplement
- Apple Health (Medicaid) Provider Manual
- Upcoming revision to Apple Health (Medicaid) Provider Manual
- Free Member Services
- Medicare provider manual
- Apple Health (Medicaid) Quick Reference Card
- Medicare Provider Dispute, Grievance and Appeal FAQ
- FCS Provider Manual
- Provider Experience Quick Reference Guide
- Credentialing Quick Tips
- Provider Orientation Feedback and Knowledge Assessment Survey
- Issue resolution and claim dispute guide
- HCA Provider Billing Guides and Fee Schedules
- Integrated Managed Care SERI, National Provider ID (NPI) & Taxonomies
- SERI Billing Guide July 1, 2018
- SERI Billing Guide July 1, 2019
- SERI Billing Guide July 1, 2021
- SERI Billing Guide July 1, 2022
- HCA SERI Guidance June 21, 2019
Medical policies and clinical UM guidelines
Medical policy addresses the medical necessity of new services or procedures and new applications of existing services or procedures. Clinical UM guidelines focus on detailed selection criteria, goal length of stay, and location for generally accepted technologies or services.
Related information
- Clinical Utilization Management Criteria February 2023
- 2023 Clinical Practice Guidelines Notification
- Site of Care Drug List
- November 2022 Clinical Utilization Management Guidelines
- August 2022 Clinical Utilization Management Guidelines
- February 2022 Clinical Utilization Management (UM) Guidelines
- November 2021 Clinical Utilization Management (UM) Guidelines
- August 2021 Clinical Utilization Management (UM) Guidelines
- May 2021 Clinical Utilization Management (UM) Guidelines
- February 2021 Clinical Utilization Management (UM) Guidelines
- November 2020 Clinical Utilization Management (UM) Guidelines
- August 2020 Clinical Utilization Management (UM) Guidelines
- BH Screening Assessment and Treatment – last updated 10/1/15
- 2022 Clinical Practice Guidelines
- Developmental screening, assessment and referral – last updated 8/21/17
- Preventive Health Guidelines
- Preventive Health Guidelines (Spanish)
- Sample Medicare Advantage Member ID Cards
- WA 2020 Benefit Grid – provider only
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Referrals
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange