DC | Providers - Amerigroup | Providers – Amerigroup

News & Announcements

Medical Policies and Clinical Utilization Management Guidelines update - March 2018
Medical Policies and Clinical Utilization Management Guidelines update - January 2018
Quarterly pharmacy formulary change notice effective August 1, 2018
Amerigroup District of Columbia, Inc. adopts 22nd edition of the MCG care guidelines
Prior authorization requirements for Cabazitaxel
Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)
Zepatier, cough and cold pharmacy formulary change notice effective June 1, 2018
Chimeric antigen receptor T-cell therapy requires prior authorization for all places of service
Services requiring prior authorization
ICS pharmacy formulary change notice update: effective April 15
Lower extremity vascular intervention codes require prior authorization
Prior authorization requirements for Darzalex drug
Electrical stimulation device to require prior authorization
Quarterly pharmacy formulary change notice effective May 1, 2018
Prior authorization requirement update for Mylotarg
Q4 Medical Policies and Clinical Utilization Management Guidelines Updates
Meningococcal vaccine update
ICS Pharmacy Formulary Change Notice
Medical Policy update - Hyaluronan Injections
2018 Utilization Management Affirmative Statement
Eight injectable drugs will require prior authorization
AIM Musculoskeletal Guidelines
Elotuzumab to require prior authorization
Welcome to the provider network family
Levoleucovorin calcium, elosulfase alfa, histrelin acetate, idursulfase and fulvestrant to require prior authorization
New Pharmacy Electronic Prior Authorization Request Tool Effective April 1, 2018
Age limits pharmacy formulary change notice effective February 1, 2018
Quarterly pharmacy formulary change notice effective February 1, 2018
Effective January 1, 2018, providers will be required to use ProView for credentialing
Alliance Behavioral Heath Inpatient and Outpatient Benefits
New review process for not otherwise classified drug codes
McKesson criteria disclosure
DHCF Open House Flier
Provider Orientation Invitation
UPDATE No/Late Notification Process
Transplant Service Request Instructions
February 2017 UPDATE to Medical Policies and Clinical Utilization Management Guidelines
Genetic Testing Services
UPDATE to Medical Policies and Clinical Utilization Management Guidelines
Prior Authorization Update for Custom Shower Chairs

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Provider Resources & Documents
expand Behavioral Health
Concurrent Review Form
Discharge Form
Mental Health Outpatient Treatment Report Form
PRTF Treatment Review Form
expand Claims Submission and Reimbursement Policy
Electronic Data Interchange (EDI)
expand Clinical Practice Guidelines
expand Disease Management Centralized Care Unit
How to Use DMCCU
expand EPSDT
EPSDT Reminder Program
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NCC Prior Authorization Form
PCP Change Form - Spanish Version
expand ICD-10
expand Manuals & QRCs
Medicaid Provider Manual
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Newborn Notification Delivery Form
Zika Virus
Obstetrical Authorization & Initial Assessment
Coding Spotlight — Pregnancy
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters - Current
2017 December Provider Newsletter
April 2018 Provider Newsletter
August 2018 Provider Newsletter
expand Pharmacy
Synagis Prior Authorization Form
Medicaid Preferred PDL
State Hepatitis C Policy: Epclusa
State Hepatitis C Policy: Mavyret
State Hepatitis C Policy: Sovaldi
State Hepatitis C Policy: Viekira
State Hepatitis C Policy: Zepatier
expand Provider Training
Availity Training
My Diverse Patients
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Medical Policies
expand Vendor/Partner Links & Information
AIM (Diagnostic and Imaging Service Authorizations)
CoverMyMeds ePA Request Tool
District of Columbia