Nevada | Providers – Amerigroup

News & Announcements

Quarterly pharmacy formulary change notice effective September 1, 2016
2016 Q2 Medical policies and Clinical Utilization Management (UM) Guidelines
Federal nondiscrimination and accessibility update
Precertification update for vascular embolization or occlusion services
Provider revalidation requirement extension
Update: Certain drugs to require prior authorization
Effective November 1, 2016 ClaimsCheck® upgrade to ClaimsXten™
Reminder: Measure members’ body mass index regularly
Quarterly pharmacy formulary change notice effective July 1, 2016
Provider appeal rights
Discontinuation of Trividia Health (formerly Nipro Diagnostics, Inc.) diabetic supplies
Precertification for knee and spine orthoses effective July 7, 2016
New vendor available for home sleep studies: Novasom™
Updated hysterectomy acknowledgment form
Update on Pharmacy Prior Authorization Submissions
Scoliosis and Spinal Deformity Medical Necessity Reviews
HCPCS billing update: Avastin for ophthalmology
Provider Newsletter
Measure members’ body mass index regularly
Enhanced Availity eligibility and benefits inquiry
Medical policies update
Diabetic Podiatry Update
Quarterly Pharmacy Formulary Change Notice
Behavioral Healthcare benefits for Amerigroup members
Q4 Medical Policies and Clinical Utilization Management Guidelines Update
Precertification for knee arthroscopy effective April 1, 2016
Precertification for knee and hip arthroplasty effective May 1, 2016
Custom molded orthotics precertification
Fluoride Update
Option 1 Healthcare Solutions designated as the exclusive enteral and parental nutrition provider
Advance directives
Hemophilia drugs medical necessity reviews
Quarterly pharmacy formulary change notice
Anesthesia claims billed without a modifier
Quarterly Formulary Change Notice Effective December 1, 2015
Amerigroup Community Care offers web-based physician visits
Q3 Medical Policies and Clinical Utilization Management Guidelines Update
Orientation Webinars Invite for Applied Behavioral Analysts
Prior authorization required for drugs Entyvio and Cyramza
Home Health Therapy Codes Update Effective November 1, 2015
Cultural Competency Training for Providers
Behavioral Health: Authorization Requirement Changes Effective October 1, 2015
Cervical Length Screening Guidelines
ICD-10 Coded Authorizations Accepted Effective June 1.
Advair Formulary Change Notice Effective July 1, 2015
Q1 Medical Policies and Clinical Utilization Management Guidelines Update​
Innovative Healthcare Delivery Partnership for Non-clinical Transition Care
Pharmacy Formulary Change Notice Effective April 1, 2015​
Medicaid PCP Rate Increase
Adult BMI Information
Patient360 Lets You Access Member Records in a Few Clicks
Pharmacy Benefit Manager Change to Express Scripts, Inc. Effective November 1, 2014​
Upcoming changes to durable medical equipment precertification requirements
Upcoming Disbursement Process Changes
Attention Behavioral Health Providers - Please respond to our brief survey to keep us informed of the services your practice currently performs.
Register Now for Availity
Availity Announcement and Frequently Asked Questions
Coming Soon! Enhanced Online Precertification Tool
Updated CMS 1500 Form
Important Phone Numbers for Providers
Las Vegas Provider Forum Invitation
Reno Provider Forum Invitation
Monthly New Provider Orientation
New Website Password Requirements
August 1 Changes to Precertification Guidelines
Medication Precertification Tool Available Now
Precertification Appeals Tool Available
Online Claims Appeals Tool Available
Updated Clinical Practice Guidelines Now Available
Preventing the Flu
Change to Clinical Utilization Management Guidelines
Proper Claims Submission Reminder
Correct Billing & Coding for Healthy Kids Services

Provider Self-Service

 Provider Resources & Documents

expand Behavioral Health
Primary Care and Behavioral Health Providers: Working Together to Treat the Whole Person Flier
Nevada Applied Behavior Analysis Overview
expand Claims Submission and Reimbursement Policy
Provider Bulletin 2014, Issue 2
Electronic Data Interchange (EDI)
expand Clinical Practice Guidelines
Clinical Practice Guidelines Matrix
expand Disease Management Centralized Care Unit
Contacting DMCCU
expand EPSDT
EPSDT Reminder Program
expand Forms
Provider Demographic Update Form
BH Concurrent Review Fax Form - Medicaid
Recoupment Notification Form
Precertification Request Form
PCP Change Request Form (Spanish)
expand ICD-10
expand Manuals & QRCs
Provider Manual
expand Maternal Child Program
17P Order Form
Prenatal Ultrasound Policy
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters
Provider News Issue 3 2012
Provider News Issue 1 2013
Provider News Issue 3 2014
Provider News Issue 2 2015​
Provider News Issue 4 2015
Provider News Issue 2 2016
expand Pharmacy
Pharmacy Tools
Preferred Drug List
Medical Injectables Prior Authorization
Common OTC Medications List
Clinical Pharmacy Policies
State Hepatitis C Clinical Criteria
expand Quality Management
expand Quick Tools
Precertification Lookup Tool
Medical Policies
expand Referral Directories
Nevada South Referral Directory
expand Training Programs
CLIA Training
Cultural Competency Training
expand Tutorials
Claims Appeals Tutorial
Precertification Request Tutorial
Medication Precertification Tutorial
expand Vendor/Partner Links & Information
LabCorp (Laboratory Services)
eyeQuest (Vision Services)
Nevada Division of Health Care Financing and Policy
Express Scripts Provider Portal
ESI Pharmacy Locator Tool
Nevada

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Join Amerigroup's Provider Network


New contract Inquiries:

If you are interested in joining the Amerigroup Community Care network, please send a letter of intent and a W9 via e-mail to nv1provsvcs@amerigroup.com or by fax to 1-866-495-8711.

Adding new providers to an existing practice:

If you are already contracted with Amerigroup and would like to add additional providers, please e-mail nvcredentialing@amerigroup.com.