We're putting down roots in Washington and are looking to partner with quality providers like you who can help us meet the unique health care needs of Medicaid recipients. We know you share our passion for helping those who need a little help, but let's face it — you're up to your neck in paperwork and regulations. Click on the links below and let us show you how we'll make it easier for you to do well by doing good.
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- We focus solely on Medicaid and other publicly funded health care programs. This is all we do — no big commercial contracts, no giant retail division, no non-health-related products. We're not distracted by other lines of business, so we can focus exclusively on the needs of vulnerable populations.
- We're committed to helping seniors and people with disabilities live independent lives and stay in their homes and communities. We serve more aged, blind and disabled members than any other Medicaid care management plan in the country.
- We're in your community. We work to make a difference where it counts — with your patients, their families and the communities they live in.
- We care for the whole person — his or her physical,
behavioral and social health.
Our Provider Services
At Amerigroup, we're all about creating real solutions in health care. That's why our Real Solutions® Provider Collaboration program is devoted to supporting you and your staff in the daily work of improving the health and quality of life of the individuals under your care. Here's what we offer:
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- Practice support. We're your practice partner, and our local Provider Relations representatives work one-on-one with you in person. We bring proven programs to improve your practice and help you give your patients the best care possible. We assist with:
- View our provider manual and frequently asked questions
- Getting your Amerigroup patients in the door
- Growing and expanding your practice
- Increasing your quality performance
- Providing health education materials and programs for your Amerigroup patients
- Handling any administrative concerns that may arise
- Extra incentives for you when you meet quality and patient outreach goals. It pays to do the right thing for your patients and our members.
- Hospital account management programs that address the specific needs of hospitals that serve Medicaid and other low-income beneficiaries.
- Web tools like meaningful reporting, helpful reminders, and constantly updated listings and eligibility of your patients who are our members. Keeping up to date with your patients means better care.
- Fast and accurate electronic claims submission and payment. Time = money, and they both need to be error-free.
- 98.2 percent claims accuracy. Getting it right means you get payments on time.
- Sophisticated claims adjudication. Our system does the up-front work to make sure your claim is submitted right the first time, getting money in your pocket more quickly.
- Quick online eligibility verification and precertification. When your patients need care, they shouldn't have to wait for approval. And that includes, for certain services, no referrals
needed within our network.
- Efficient precertification requirements to minimize the administrative burden on your practice. Your office has enough paperwork to deal with. We make things as easy as possible.
- Toll-free provider service line with live agents during business hours and telephonic functions available. If you have a question or need information, drop us a line. We're at your service and ready to help.
- A 24/7/365 Nurse HelpLine for members. Health care isn't a 9-to-5 job. We want to make sure your patients are cared for if they get sick or hurt, even in the middle of the night.
- Our provider website where you can download provider manuals, communications and other reference materials. We keep it all online in one place so you can find it easily.
- Direct deposits to designated provider accounts. No trips to the bank. No deposit slips. No waiting for checks to clear. No kidding.
- Innovation in how we work with providers. We've worked with PCPs to set up patient-centered medical homes. We've provided on-site case managers at FQHCs and CMHCs to help coordinate care. We've helped set up after-hours programs and urgent care centers. And innovation doesn't have to be high-tech; we'll even create reference cards to help your staff enter claims more quickly.
- We listen to our providers by convening medical advisory committees and provider panels to work with us to improve our processes and ensure we're doing the right thing by our members.
Our Member Programs
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- Health risk assessments so your Amerigroup patients have a chance to find out what's wrong early enough to take care of it quickly and completely. We help our members get preventive screenings and tests to stay healthy.
- Disease management programs to help your Amerigroup patients understand their chronic conditions and keep on top of their treatments. The more they know, the better they can care for themselves, and the easier your job is.
- Taking Care of Baby and Me® and prenatal case management programs that help expectant moms have healthy babies. We educate your pregnant Amerigroup patients about the physical and emotional challenges of pregnancy and assist them during labor, delivery and after the birth of their babies.
- Health and nutrition education programs so your Amerigroup patients learn about the importance of exercise and healthy eating.
Want proof of how we're a different kind of health insurance company? Take a look at our Real Stories video series. And see how we work with providers like you to improve our members' lives.