Washington | Providers – Amerigroup
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Provider Resources & Documents
expand Behavioral Health
BH Interactive Care Reviewer Training Presentation
expand Claims Submission and Reimbursement Policy
HCA Provider Billing Guides and Fee Schedules
SERI Billing Guide July 1, 2018
HCA SERI Guidance June 21, 2019
expand Clinical Practice Guidelines
BH Screening Assessment and Treatment – last updated 10/1/15
Preventive Health Guidelines
Clinical Practice Guidelines Matrix
expand Disease Management
Contacting Disease Management
Disease Management Referral Form
expand EPSDT
EPSDT Provider Training
EPSDT Toolkit - Spanish
expand Forms
Behavioral Health Concurrent Review Medicare
Behavioral Health Outpatient Treatment Report Medicare
expand HEDIS Training
HEDIS Behavioral Health Presentation
HEDIS Pediatric screening and prevention measures presentation
expand ICD-10
Medicare Advantage Medical Record Documentation & Coding Tips
expand Manuals & QRCs
No Cost Member Services
Medicaid Quick Reference Card
Provider Manual Addendum for Service Encounter Reporting Instruction (SERI)
expand Maternal Child Program
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
Prenatal Ultrasound Policy
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters - Archived
April 2018 Provider Newsletter
August 2018 Provider Newsletter
December 2018 Provider Newsletter
April 2019 Provider Newsletter
expand Newsletters - Current
August 2019 Provider Newsletter
December 2019 Provider Newsletter
April 2020 Provider Newsletter
expand Pharmacy
Medical Injectables Prior Authorization
Pharmacy Benefits Page
Synagis Enrollment Form
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
National drug code: frequently asked questions
Medicare Advantage 2020 Products
Sample Medicare Advantage Member ID Cards
expand Training
expand Training Programs
Cultural competency and patient engagement
DSNP Overview Training
My Diverse Patients Training: Creating an LGBT-Friendly Practice
My Diverse Patients
Consumer Assessment of Healthcare Providers and Systems
Ask Me 3 Questionnaire (both Eng and Spn)
Ask Me 3 Flier - Spanish
Improving the Patient Experience CME
2018 Apple Health Medicaid Provider Training
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)
AIM (Diagnostic and Imaging Service Authorizations)
PACLAB, LLC (a joint venture with PAML in Western WA)
eyeQuest (Vision Services)
expand Women Infants and Children

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.