Texas | Providers – Amerigroup
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News & Announcements

Medicare Advantage: Precertification Required on Four New Part B Injectables
Encourage Medicare Advantage Members to Stay Up-to-Date on Preventive Care
Retroactive TPI Assignment and the Claims Process: Update
Medicare Advantage - OrthoNet to conduct post service prepay reviews
Medicare Advantage - ClaimCheck Version 55 Upgraded Effective April 1, 2015
Medicare Reimbursement Policy Bulletin 2015, Issue 1
Maternity Services Reimbursement Policy Update
Medicare Advantage: Medicare Update to Pneumococcal Vaccine Policy
WellPoint, Inc. is now Anthem, Inc.!​
Medicare Advantage - Clearing House Helps Ensure Timely and Accurate Claims Payment for Vaccines Covered by Medicare Part D
Medicare Advantage: Medicare Immune Globulin Home Infusion Therapy Part B Coverage Reminder
Provider Manual Update: PPR and PPC Information​
Medicare Advantage national coverage determinations
Medicare Advantage: Amerigroup Community Care, Optum Collaborating To Ensure Members Receive Regular Exams, Preventive Screenings
Medicare Advantage: OrthoNet to Conduct Medical Necessity Reviews, Professional Service Coding Reviews
2015 Nursing Facility Training Schedule​
2015 Dallas/Tarrant and MRSA Webinar Training Schedule
New 2015 Medicare Advantage precertification fax number for skilled nursing, long term acute care and inpatient rehab
Medicare Amerivantage PBM Conversion
PCP Rate Increase Decommissioning Bulletin​
Medicare Advantage: Provider Requirements and Medicare Notices
Medicare Advantage 2015 Annual Notice of Change in Products
Patient360 Lets You Access Member Records in a Few Clicks
Newborn Diagnostic Related Group Precertification and Claims Processing
New Federally Qualified Health Center Billing Guidelines in Effect for Original Medicare
Flu Vaccinations
Service Area Change Fax
Medicare Advantage Peer to Peer Changes
Inpatient Readmissions
Encourage Exercise to Prevent Falls
Postponed: Upcoming Disbursement Process Changes
Now Available Online: Updated Medicaid/CHIP Provider Manual
Upcoming changes to durable medical equipment precertification requirements
Availity Announcement and Frequently Asked Questions
Nonemergent Transportation Update
2013 Quality Improvement Summary
Updated Information on Targeted Case Management and Mental Health Rehab Services​
Upcoming Disbursement Process Changes
HIPPS Codes Required for All Skilled Nursing and Home Health Providers
Attention Behavioral Health Providers - Please respond to our brief survey to keep us informed of the services your practice currently performs.
Targeted Case Management and Mental Health Rehab Services
Bone Density Testing for Medicare Members
Medicare Advantage Members to Receive Monthly Summary Statements
Update to Requirements for Obstetric Delivery Claims and Diagnosis Codes
Effective July 21: Update to Requirements for Ordering or Referring Claim Submissions
Upcoming Changes to Amerivantage (Medicare Advantage) Precertification Requirements
Updated CMS 1500 Form
Help Us Locate Children of Farmworkers
Improving Access to Behavioral Health Providers and Services
Texas Nonemergent Transportation Changing to Access2Care
Notification of Web Search Tool
El Paso Lubbock Medicare Advantage Product Highlights Provider Letter
Dallas Ft. Worth Medicare Advantage Product Highlights Provider Letter
San Antonio Medicare Advantage Product Highlights Provider Letter
Houston Medicare Advantage Product Highlights Provider Letter
REMINDER: Personal Attendant Services Timesheet Signature Requirement
Hospital Corporations of America (HCA) Returns to Network
Attendant Care Enhancement Program Open Enrollment
Prior Authorization Requirements Update - Nutritional Formulas
2013 Legislative Changes Summary (Professional, Ancillary, and Facility)
New Website Password Requirements
Precertification Requirements Training
Medicare Requirements for Outpatient Therapy Claims
Medication Precertification Tool Available Now
The New Electronic Health Risk Assessment Form
HEDIS Requirements for DMARD Therapy for Rheumatoid Arthritis
Precertification Appeals Tool Coming Soon
Online Claims Appeal Tool Coming Soon
The Medicare Health Outcomes Survey
CMS fact sheets about the rate increase for primary care providers
Assess and strengthen your cultural competency
Our Medicaid ID cards have gone mobile!
We launched our newly designed online provider directory in September. Try it here.
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Provider Self-Service

 Provider Resources & Documents

expand Behavioral Health
Screening, Brief Intervention and Referral to Treatment (SBIRT) Flier
Behavioral Health Case Management Flier
expand Claims Submission and Reimbursement Policy
EDI Overview
Provider Bulletin 2014, Issue 1
Provider Bulletin 2014, Issue 3
expand Clinical Practice Guidelines
Adult Hypertension
Adult Preventive Health
BH Screening Assessment and Treatment
Bipolar Disorder - Adults
Childhood Obesity
Chronic Kidney Disease
Chronic Obstructive Pulmonary Disease
Diabetes Mellitus
High Risk OB
Immunizations
Postpartum Care
Schizophrenia
Substance Use Disorders - Adults
expand Disease Management Centralized Care Unit
Contacting DMCCU
expand EPSDT
EPSDT Reminder Program
expand Forms
Precertification Request Form
Therapy Preauthorization Request
Nonemergent Transportation Prior Authorization Request Form
BH Initial Review Fax Form - Medicaid
BH Concurrent Review Fax Form - Medicare
expand ICD-10
expand Manuals & QRCs
Medicare Quick Reference Card
Provider Quick Reference Card
expand Maternal Child Program
Maternity Notification Form
Program Overview
expand Medical Management Model
Care Management
Medical Management Model
expand MultiPlan
Texas True Choice Flier
expand Newsletters
Provider News Issue 1 2013
Provider News Issue 3 2012
Provider News Issue 4 2013
expand Pharmacy
Pharmacy Tools
Synagis Enrollment Form
Texas Vendor Drug Program Clinical Edits
expand Quality Management
Medicare Advantage – Clinical HEDIS Medicare Stars Quick Reference Guide
expand Quick Tools
Reimbursement Policies
expand STAR+PLUS Medicare-Medicaid Plan program
Dual Eligibles Integrated Care Demonstration Project FAQs
BH Concurrent Review Form
BH Discharge Note
BH Outpatient Treatment Form
STAR+PLUS MMP Provider Orientation
expand State Communications
Medicaid EVV Provider System Selection Form
expand Training Programs
Texas Cultural Competency Plan
Orientation Calendar - March
expand Tutorials
Claims Appeals Tutorial
Precertification Status and Appeals Tutorial
Provider Updates: Account Information
expand Vendor/Partner Links & Information
Block Vision (Vision Services)
LabCorp (Laboratory Services)
Texas Department of Aging and Disability Services
Health and Human Services Commission
Clinical Pathology Laboratories (CPL)
STAR+PLUS and IDD: What to Expect (Video Link)
Express Scripts Provider Portal - Medicare
Texas

Do more online by registering for Provider Self-Service!

Through Provider Self-Service, you can:

  • File and check the status of medical claims
  • Verify eligibility
  • Request precertification
  • Submit a Pharmacy Prior Authorization Request
  • And much more!

How are you accessing patient information?

Online member eligibility, benefit and claim status inquiries are available at www.Availity.com. Avoid business disruptions – work with your office staff today to register for and begin using the Availity Web Portal.

Visit Frequently Asked Questions about Availity for more information.



Join Amerigroup's Provider Network

In a Rural Service Area (RSA) county?

We are contracted with the MultiPlan, Inc. (MPI) Texas True Choice (TTC) network for the RSA as our network. To become a participating provider with TTC, please call 1-866-971-7427 or submit your request for application.

In a non-RSA county?

Call our Texas Centralized Credentialing department at 713-218-5112.