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
Electronic Data Interchange (EDI)
Integrated Managed Care SERI, National Provider ID (NPI) & Taxonomies
SERI Billing Guide July 1, 2019
How to Submit a Corrected Claim
expand Clinical Practice Guidelines
Developmental screening, assessment and referral – last updated 8/21/17
Preventive Health Guidelines (Spanish)
expand Disease Management
About Disease Management
How to Use Disease Management
expand EPSDT
EPSDT Reminder Program
EPSDT Toolkit - English
expand HEDIS Training
HEDIS Adult prevention and screening presentation
HEDIS Chronic condition management and CAHPS 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
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
Prenatal Ultrasound Policy/ICD-10 Update
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters - Archived
April 2019 Provider Newsletter
expand Newsletters - Current
August 2019 Provider Newsletter
December 2019 Provider Newsletter
April 2020 Provider Newsletter
expand Pharmacy
Pharmacy Tools
Find A Pharmacy
Synagis Enrollment Form
Opioid Attestation
expand Quality Management
HEDIS Desktop Reference Guide for Medicaid Providers
Advance directives or physician orders for life-sustaining treatment
expand Quick Tools
Precertification Lookup Tool
Medical Policies and UM Guidelines
Credentialing Quick Tips
National drug code: frequently asked questions
Medicare Advantage 2020 Products
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
2019 Apple Health Medicaid Provider Training
Medicare Special Needs Plans (SNPs) and Model of Care (MOC) overview
expand Tutorials
Precertification Status and Appeals 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)

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.