UH - Managed Care Office

Office of Managed Care Operations

AMERIGROUP

	Quick Reference Guide
	Telephone Guide
	Claims Address
	Amerigroup Website -(This link is provided for the convenience of our website visitors. UMDNJ University Hospital takes no responsibility for the information or proprietary of the web sites listed above.)

AMERIGROUP COMMUNITY CARE QUICK REFERENCE GUIDE

Facility/Provider # 50061

ELECTIVE	REQUIREMENTS
Inpatient Admission	Authorization Required
Same Day Surgery	Authorization Required
Out Patient Procedure	Authorization Required

NOTE: Admitting Physician must call to obtain authorization @ 1-800-454-3730 (precertification). Hospital admitting department must call Amerigroup prior to admission or surgery to make sure admission or surgery has been authorized.

EMERGENCY/DIRECT

EMERGENCY ROOM VISIT	Notification is not required by Hospital to obtain authorization for visit unless patient is admitted
EMERGENCY ADMISSION	24-hr notification required by Hospital to obtain authorization
DIRECT ADMISSION	24-hr notification required by Physician or Hospital to obtain authorization
MENTAL HEALTH/ADMISSION SUBSTANCE ABUSE	See note below
NON EMERGENCY MENTAL HEALTH	See note below

NOTE: All Mental Health and Substance Abuse Admission must be billed to Medicaid Fee-For-Service. To obtain further information regarding Behavioral Health Services call 1-800-356-1561 (Exception: Amerigroup Behavioral Health Services coverage is limited to members who are clients of the Division of Developmental Disabilities (DDD) .

AMERIGROUP QUICK REFERENCE GUIDE

Referral/Pre-Auth. Requirements for Outpatient Services

REFERRAL OR SCRIPT REQUIRED-OUTPATIENT

PRE AUTHORIZATION REQUIRED OUTPATIENT

Specialist Visit (script required)

Non Emergent Ambulance (Transpt)

OB/GYN Visit (script required)

MRI/MRA

Audiology Services (call Case Management)

Telephone # 1-800-454-3730

Ultrasound (Non OB related)

Routine X-Ray (Script required)

CT Scan/PET Scan

EKG/EEGs

Rehab - Cardiac

Hospital Vision Care

Therapy PT/RT/OT Speech

Radiation Therapy

Laboratory Services

Dialysis

Chem Depend

Oral Surgery

Radiology Routine

Hospice

Educational Consults

Durable Medical Equipment / Prosthetic and Orthotics

NOTE: Amerigroup does not cover Mental Health Services & Chem Depend. Must bill Medicaid fee-for-services for these services (except for clients of DDD).

AMERIGROUP TELEPHONE GUIDE

AMERIGROUP Community Care Provider Representative DEBORAH HAND	(732) 452-6000 ext. 66137
AMERIGROUP Education & Outreach Representative VICTORIA HAWKINS	(732) 453-4080 ext. 6148
AMERIGROUP Utilization Management Coordinator MICHELLE KRUG	(732) 452-6000 ext. 66196
AMERIGROUP Member Services	1-800-600-4441
AMERIGROUP Provider Relations	1-800-454-3730
AMERIGROUP Quick Reference for Referrals	1-800-454-3730
AMERIGROUP Quick Reference for Referrals Fax #	1-800-964-3627
AMERIGROUP Authorization & Case Management	1-800-454-3730
AMERIGROUP Dental Care	1-800-600-4441
Vision Service Plan (VSP) Medicaid	1-800-438-4560
AMERIGROUP 24-hr Nurse-on-Call	1-800-600-4441

AMERIGROUP CLAIMS ADDRESS

AMERIGROUP
P.O. BOX 61659
VIRGINIA BEACH, VA 23466-1659

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