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 Provider Resources & Documents

expand Claims Submission and Reimbursement Policy
expand Clinical Practice Guidelines
BH Screening Assessment and Treatment – last updated 10/1/15
2017 Preventive Health Guidelines
Clinical Practice Guidelines Matrix
expand Disease Management Centralized Care Unit
Contacting DMCCU
Disease Management Referral Form
expand Enhanced Personal Health Care Program
Measurement Period Handbook
Program Description for the EPHC
expand EPSDT
EPSDT Reminder Program
EPSDT Toolkit - English
expand Forms
Hysterectomy & Sterilization Forms
Growth Hormone for Adults Request
OB/GYN Encounter Form
Provider Payment Dispute and Correspondence Submission Form
Provider Demographic Update Form
BH Outpatient Treatment Report
BH Concurrent Review Fax Form - Medicare
DSM-5 Checklist
Precertification Request Form
Functional Progress Chart
Hospital Communication Log
Request for a Change of Primary Care Provider
Practice Profile Update Form
Neuropsychological Testing Request Form Medicare
Outpatient Therapy Initial Evaluation Form
Electroconvulsive Therapy Prior Authorization Request Form
Member Consent for Appeal Form
Substance Use Disorder Withdrawal Management Prior Authorization and Continued Care Request
expand ICD-10
Medicare Advantage Medical Record Documentation & Coding Tips
expand Manuals & QRCs
No Cost Member Services
Medicare Provider Manual
Medicare Provider Dispute, Grievance and Appeal FAQ
expand Maternal Child Program
Prenatal ultrasound reimbursement
Breast pump request form
Zika Virus Information Packet
Long-acting, reversible contraception device inventory and separate inpatient reimbursement
OB Department Chair notification letter regarding long-acting, reversible contraceptive devices
Coding Spotlight — Pregnancy
expand Medical Management Model
Health Education and Wellness
expand Newsletters - Archived
April 2015 News Bulletin
August 2016 News Bulletin
February 2015 News Bulletin
January 2015 News Bulletin
July 2016 News Bulletin
June 2015 News Bulletin
March 2015 News Bulletin
May 2015 News Bulletin
November 2015 News Bulletin
October 2016 News Bulletin
September 2016 News Bulletin
December 2016 News Bulletin
February 2017 News Bulletin
April 2017 News Bulletin
June 2017 News Bulletin
August 2017 News Bulletin
October 2017 News Bulletin
2017 December Provider Newsletter
expand Newsletters - Current
April 2018 Provider Newsletter
August 2018 Provider Newsletter
expand Pharmacy
Washington Formulary
Synagis Enrollment Form
OTC Preferred Drug List
Opioid Clinical Criteria - State Policy
Opioid PA with Attestation Form
Medication Assisted Treatment Form - Patient Status
Washington Preferred Drug List
expand Quality Management
Quality measures desktop reference for Medicare and Medicaid providers.
Advance directives or physician orders for life-sustaining treatment
expand Quick Tools
Precertification Lookup Tool
Medical Policies
Credentialing Quick Tips
Women’s Health Quick Tips
expand Referral Directories
Washington West Referral Directory
expand Training Programs
Cultural Competency Toolkit
Moving Toward Equity in Asthma Care CME
DSNP Overview Training
My Diverse Patients Training: Creating an LGBT-Friendly Practice
My Diverse Patients
expand Tutorials
Precertification Status and Appeals Tutorial
Provider Updates: Account Information
Medication Precertification Tutorial
expand Vendor/Partner Links & Information
LabCorp (Laboratory Services)
Quest Diagnostics, Inc. (Laboratory Services)
AIM (Diagnostic and Imaging Service Authorizations)
Pathology Associates Medical Laboratories, LLC (PAML)
Tri-Cities Laboratory
AIM (Chemotherapy and Therapeutic Authorizations)

Do more online through Provider Self-Service!

  • File and check the status of medical claims
  • NEW — Submit Claims Payment Disputes electronically via Availity
  • Verify eligibility
  • Request precertification via the Interactive Care Reviewer (ICR)
  • Conduct an inquiry on the status of any precertification request via ICR
  • For more information on ICR such as features, support or training go to
  • Submit a Pharmacy Prior Authorization Request
  • And much more!

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Amerigroup Washington, Inc.'s rating increased from 3.0 to 3.5 out of 5 in NCQA's Private Medicaid Health Insurance Plan Ratings 2017-2018.