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 Provider Resources & Documents

expand Behavioral Health
expand Claims Submission and Reimbursement Policy
Electronic Data Interchange (EDI)
expand Clinical Practice Guidelines
Developmental screening, assessment and referral – last updated 8/21/17
2017 Preventive Health Guidelines (Spanish)
expand Disease Management Centralized Care Unit
How to Use DMCCU
expand Enhanced Personal Health Care Program
Medicare Advantage Medical Panels
Program Overview
Availity Access for EPHC
expand EPSDT
EPSDT Provider Training
expand FCS
Department of Commerce Coordinated Entry Information
expand Forms
Hysterectomy & Sterilization Forms
Growth Hormone for Adults Request
OB/GYN Encounter Form
Outpatient Therapy Progress Report
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
expand 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
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters - Archived
April 2016 News Bulletin
December 2015 News Bulletin
February 2016 News Bulletin
January 2016 News Bulletin
July/August 2015 News Bulletin
June 2016 News Bulletin
March 2016 News Bulletin
May 2016 News Bulletin
October 2015 News Bulletin
September 2015 News Bulletin
November 2016 News Bulletin
January 2017 News Bulletin
expand Newsletters - Current
March 2017 News Bulletin
May 2017 News Bulletin
July 2017 News Bulletin
September 2017 News Bulletin
November 2017 News Bulletin
February 2018 Provider Newsletter
expand Pharmacy
Washington Formulary
Synagis Enrollment Form
Medication Assisted Treatment Form - Buprenorphine Naloxone
Washington Preferred Drug List
ESI Mail Order Form
Opioid PA with Attestation Form
expand Quality Management
Quality measures desktop reference for Medicare and Medicaid providers.
Advance directives or physician orders for life-sustaining treatment
expand Quick Tools
Reimbursement Policies
Requesting preauthorization for the Bariatric Surgery program
Tribal Quick Tips
expand Referral Directories
Washington East Referral Directory
expand Resources
FCS Referral Form
expand Training Programs
Cultural Competency Toolkit
Moving Toward Equity in Asthma Care CME
DSNP Overview Training
My Diversepatient Training: Creating an LGBT-Friendly Practice
My Diversepatient Training: Medical Consumerism
expand Tutorials
Claims Appeals Tutorial
Precertification Request Tutorial
Member Information and Panel Listing
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

Do more online through Provider Self-Service!

  • File and check the status of medical claims
  • 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.