Washington | Providers – Amerigroup
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Provider Self-Service

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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
Basic Skills Training/Social Skills Training
Neuropsychological Testing
Psychiatric Disorder Treatment
Psychosocial Rehabilitation Services
Targeted Case Management
expand Disease Management Centralized Care Unit
About DMCCU
How to Use DMCCU
expand Enhanced Personal Health Care Program
Medicare Advantage Medical Panels
Program Overview
Availity Access to Reports
expand EPSDT
EPSDT Provider Training
EPSDT Tookit - Spanish
expand Forms
Family Practice Encounter Form
Internal Medicine Encounter Form
Pediatric Encounter Form
Refund Notification Form
Training Verification Form
BH Initial Review Fax Form - Medicare
Exception to the Rule Request Form
Psychological Testing Request Form
Provider authorization to create claims offset
Blood Lead Testing for High-risk Children
Member Agreement to Pay for Healthcare Services
Request for a Change of Primary Care Provider - Spanish
Neuropsychological Testing Request Form
Physician Orders for Life-Sustaining Treatment Form
Outpatient Therapy Progress Report Form
WISe/PACT Notification Form
Case Management Services Referral Form
Claim Payment Reconsideration Submission Form
expand ICD-10
ICD-10
expand Manuals & QRCs
Washington Provider Manual
Medicare Quick Reference Card
Medicaid Quick Reference Card
expand Maternal Child Program
Prenatal Ultrasound Policy
Maternity Notification Form
Healthy Rewards
New separate reimbursement for long-acting, reversible contraception devices
Provider notification letter regarding long-acting, reversible contraceptive devices with FAQ
Medically Intensive Children's program
New case management program for PTSD resulting from stays in the NICU
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
Pharmacy Tools
Natn'l Drug Code FAQs
Medical Injectables Prior Authorization
ESI Mail Order Form
Prior Authorization Form
Prescribing Medication Assisted Treatment (MAT)
Clinical Guidelines and Coverage Limitations for Medication Assisted Treatment
expand Quality Management
Medicare Advantage – Clinical HEDIS Medicare Stars Quick Reference Guide
Medicare Quality Improvement Programs
HEDIS Benchmarks and Coding Guidelines
expand Quick Tools
Reimbursement Policies
Requesting preauthorization for the Bariatric Surgery program
Tribal Quick Tips
expand Training Programs
Cultural Competency Training
Medicare Advantage Asthma Care Training
DSNP Plan FAQs
My Diverse Patients Training: Breast Cancer Screening for African American Women
My Diverse Patients Training: Reducing Health Care Stereotype Threat
New Provider Orientation Presentation
expand Tutorials
Claims Appeals Tutorial
Precertification Request Tutorial
Member Information and Panel Listing
Accessing remittance inquiry process guide
expand Vendor/Partner Links & Information
Washington Health Care Authority (HCA)
Express Scripts Provider Portal
ESI Pharmacy Locator Tool
PACLAB, LLC (a joint venture with PAML in Western WA)
eyeQuest (Vision Services)
Washington

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
    ICR-Help
  • Submit a Pharmacy Prior Authorization Request
  • And much more!

To log in, use your Availity ID and password. If you need an Availity ID, visit www.Availity.com to register today.

Visit Frequently Asked Questions about Availity for more information.

NCQA Health Plan Commendable logo NCQA MHC Distinction Seal

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.