Arizona | Providers – Amerigroup

News & Announcements

Medicare Advantage — Clinical Criteria Web Posting June 2020
Medicare Advantage — New Specialty Pharmacy Medical Step Therapy Requirements - Effective 1/1/2021
Medicare Advantage — Provider Notification for UM AROW 1107
Medicare Advantage — Provider Notification for UM AROW 1125
Medicare Advantage — Evaluation and management services correct coding
Medicare Advantage — May 2020 Medical Policies and Clinical Utilization Management Guidelines update
Medicare Advantage Clinical Criteria Web Posting May 2020
Medicare Advantage — Amerigroup expands specialty pharmacy precertification list
Medicare Advantage — Transition to AIM Specialty Health Rehabilitative Services Clinical Appropriateness Guidelines
Medicare Advantage — New MCG Care Guidelines 24th edition Viral Illness
New Specialty Pharmacy Medical Step Therapy Requirements - Effective August 1, 2020
Medicare Advantage — Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
Medicare Advantage — Amerigroup expands specialty pharmacy precertification list (Effective 9/1/2020)
Medicare Advantage — Submit behavioral health authorizations via our online Interactive Care Reviewer tool
Medicare Advantage Clinical Criteria Web Posting March 2020
Updates to AIM musculoskeletal program clinical appropriateness guidelines
Medicare Advantage — Updates to AIM Specialty Health advanced imaging Clinical Appropriateness Guidelines
Medicare Advantage - New behavioral health discharge call-in line
Medicare Advantage - February 2020 Medical Policies and Clinical Utilization Management Guidelines Update
Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline
Medicare Advantage — Modifier use reminders
Medicare Advantage Resources supporting our providers during COVID-19
Medicare Advantage Clinical Criteria Web Posting February 2020
Amerigroup expands specialty pharmacy precertification list
Medicare Advantage — Amerigroup working with Optum to collect medical records for risk adjustment
Medicare Advantage - Acquisition of Beacon Health Options
Medicare Advantage MCG care guidelines — 24th edition
Medicare Advantage - Electronic submission is preferred method for requesting pharmacy prior authorization
Medicare Advantage - Prior authorization requirements
New behavioral health Medicare Advantage provider fax beginning March 30, 2020
Medicare Advantage - Prior authorization requirements: new 2020 codes for coverage and precertification
Medicare Advantage Clinical Criteria Web Posting December 2019
Medicare Advantage - November 2019 Medical Policies and Clinical Utilization Management Guidelines update
New Medicare Advantage Opioid Treatment Program benefit
Medicare Advantage - Coding tip for psychological and neuropsychological testing
Medicare Advantage Clinical Criteria Web Posting November 2019
Update on Personal Home Helper supplemental benefit for Medicare Advantage Members
Procedures for submitting referrals for Medicare Advantage embedded supplemental benefits requiring precertification
Procedures for submitting referrals for Medicare Advantage meal benefits requiring precertification
Prior authorization requirements for CardioMEMS
New CMS requirement: Hospitals must use Medicare Outpatient Observation Notice
Updated claims submission requirements for in-home support, respite care benefits in Arizona
Updated claims submission requirements for adult day center
Expansion of Specialty Pharmacy Precertification List: Zirabev
2020 Medicare risk adjustment provider trainings
Multiple and Bilateral Surgery: Professional and Facility Reimbursement Policy Update
New Specialty Part B Preferred Device - Effective January 17, 2020
Medicare New Specialty Pharmacy Medical Step Therapy Requirements - Effective January 17, 2020
Medicare Advantage - Clinical Criteria Web Posting September 2019
Medicare Advantage: Pharmacy Benefit Manager Change to IngenioRx - Effective 1/1/2020
AZ 2020 Medicare Advantage plan changes
Prior authorization requirements for E0784, K0553 and K0554
Medicare Advantage - Clinical Criteria Web Posting August 2019
Provider training series
Medicare Advantage - CMS reminder: expedited/urgent requests
Global 3M19 Medical Policy and Technology Assessment Committee prior authorization requirement updates
Medicare Advantage - Aspire Telehealth Palliative Care Program bulletin 
Medicare Advantage - June 2019 Medical Policies and Clinical UM Guidelines update
2019 Enhanced Personal Health Care Program releases myFHR
Medicare Advantage - Medicare Preferred Cont Glucose Monitors
Clinical Criteria Web Posting July 2019
Medicare Advantage - 2019 Risk Adjustment Provider Trainings
Assisting your patients in managing the Donut Hole
Lowering health risks with no-cost statins
Prior authorization requirements for continuous positive airway pressure supplies
Medicare Advantage – CLIA for Amerigroup
Medicare Advantage – Pharmacy benefit manager change to IngenioRx
Medicare Advantage – Clinical Criteria Web Posting Q1 2019
AGP Customization for IP Cancer Therapy
Medicare Advantage – Clinical Criteria Web Posting Q2 2019
Upgrade to 23rd Edition of MCG Care Guidelines
Update to Emergency Department: Level of E&M Services Reimbursement Policy (Medicare-Advantage Only)
2019 Utilization Management Affirmative Statement concerning utilization management decisions
Medicare Advantage – Medical records request for risk adjustment
Update: Medicare Advantage – 2019 risk adjustment provider trainings
Update: Medicare Advantage – Submitting corrected claims
Medicare Advantage – Partial hospitalization services
Medicare Advantage – Fall prevention tips
Revision to Facility Emergency Department reimbursement policy postponed
Medicare Advantage - Update: 2019 Risk Adjustment provider trainings
Medicare Advantage – Change to 835 ERA for all D-SNP MA members for 2019
Medicare Advantage – Special Need Plans training required
Medicare Advantage – Clinical criteria updates for specialty pharmacy
Medicare Advantage – Amerigroup eye refraction and routine eye exam billing information

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