Amerigroup at a glance
| Legal name | Amerigroup Corporation |
|---|---|
| Also known as | Amerigroup Community Care |
| Category | Medicaid MCO |
| Parent organization | Elevance Health, Inc. |
| Claims payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Amerigroup. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| NAIC company code | Not established in this registry |
| States covered | Georgia, Iowa, Kansas, Louisiana, Maryland, Nevada, New Jersey, New Mexico, New York, Tennessee, Texas, Washington |
| Members covered | ~6.0 million members |
| Provider resource entry point | https://provider.amerigroup.com/ |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Amerigroup
For the Georgia programs covered by policy G-06050, initial claims must be received and accepted within six months following the month services were rendered, unless contractual or governmental requirements differ. With other primary insurance, the policy starts the clock at that carrier's EOP. This is a Georgia reference, not a national Amerigroup deadline or a 180-day conversion.
| Submission type | Window |
|---|---|
| Initial claim reference | Market specific; Georgia: six months following the service month |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Amerigroup. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Amerigroup provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Amerigroup
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Amerigroup electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Amerigroup. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Amerigroup
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Amerigroup volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This registry has not established one national ERA payer ID for Amerigroup. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
What revenue cycle teams should verify before submitting claims
- Select the current state brand and member product before claims, contact or enrollment decisions; a rebrand is not termination of coverage.
- The October 2023 NJ notice describes the January 2024 Wellpoint transition. Do not copy its WLPNT/26375 mapping into national claims, eligibility or ERA fields.
- Portal descriptions and historical transaction lists do not establish current all-market X12 capability or authenticated access.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
portal_url, current market/brand scope
Source comparison: 2026-09-18
Provider resources use the singular provider.amerigroup.com host. The checked landing page still presents Georgia and links other differently branded markets; it does not certify the historical registry footprint or show that the whole Amerigroup brand is inactive. Locator: Amerigroup Providers and other markets. The 2021 footer is not a newly established effective date.
Primary source for portal_url, current market/brand scopetimely_filing_days, filing_rule, source version
Source comparison: 2026-09-18
The universal 90-day scalar was withdrawn. Georgia policy G-06050 requires initial claims to be received and accepted within six months following the month services were rendered, subject to provider/governmental requirements; other primary insurance uses the carrier EOP as the starting event. This is not a 180-day conversion or national rule. Locator: PDF page 1, visually inspected. Approval/effective date June 3, 2025; visible footer April 2026.
Primary source for timely_filing_days, filing_rule, source versionprovider_phone, contact scope
Source comparison: 2026-09-18
The Georgia contact page lists 1-800-454-3730 for Provider Services and a different nurse line. Keep the umbrella phone blank rather than promoting a Georgia contact nationally. Locator: Provider Services; no phone functionality was tested.
Primary source for provider_phone, contact scopehistorical rebrand, transaction IDs and capabilities
Source comparison: 2026-09-18
The October 2023 NJ notice describes the January 2024 Wellpoint website and 26375/WLPNT transaction transition. It is historical, state/product-scoped evidence, not verification of one current national ID or every capability. The document also describes transition overlap; do not declare an old identifier invalid in every context. Locators: PDF pages 1-3 visually inspected and page 4 text.
Primary source for historical rebrand, transaction ids and capabilities
Not checked in this pass: Exact legal underwriting entity/NAIC, enrollment totals and complete current geographic/product coverage; All contracts, delegated routes, filing exceptions and complete dispute/appeal ladders; Every transaction-specific identifier, enrollment process and electronic capability; no authenticated portal or phone test; Clinical criteria and current authorization code lists; QuickIntell integrations/outcomes and historical April 2026 DataForSEO demand; Accountable whole-record approval; all last_reviewed and reviewed_by values remain unchanged.
Sources used for this guide
State coverage
Amerigroup operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Amerigroup
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Amerigroup; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Amerigroup; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Amerigroup before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Amerigroup
Where is the Amerigroup provider portal?
Use https://provider.amerigroup.com/ as a starting point for Amerigroup provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Amerigroup?
For the Georgia programs covered by policy G-06050, initial claims must be received and accepted within six months following the month services were rendered, unless contractual or governmental requirements differ. With other primary insurance, the policy starts the clock at that carrier's EOP. This is a Georgia reference, not a national Amerigroup deadline or a 180-day conversion.
Does Amerigroup publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Amerigroup. See the source findings for transaction-specific references. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Amerigroup accept electronic claims?
Verify Amerigroup electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Amerigroup denial?
This registry has not established a payer-specific appeal ladder for Amerigroup. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Amerigroup prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact Amerigroup?
This registry has not established one provider phone number for Amerigroup. No national Amerigroup provider number was established. The checked Georgia page lists 1-800-454-3730 for Provider Services; that is not an all-market line. Confirm the member product and current state brand before contacting the plan. Use https://provider.amerigroup.com/ as a starting point for Amerigroup provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
Automate workflows around Amerigroup requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Amerigroup's current published documents before submission. CPT® is a registered trademark of the American Medical Association.