New Mexico Provider and Pharmacy Directory - Amerigroup

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SSO-ALL-0315-11 Medicare HMO Plan Provider Directory This directory provides a list of Amerigroup network providers. This directory is for New Mexico � Bernalillo, Otero, Sandoval, Santa Fe, Socorro, Torrance and Valencia counties. This directory is current as of September 5, 2011. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Amerigroup network providers in your area, you can visit www.myamerigroup.com/medicare or call our Member Services department at 1-866-805-4589, 8:00 a.m. to 8:00 p.m. local time, 7 days a week. TTY users should call 1-800-855-2880. Amerigroup is an HMO plan with a Medicare contract. This information is available for free in other languages. Please contact our customer service number at 1-866-805-4589 for additional information. This document may be available in alternate formats such as Braille, large print or audio. Y0005_12 Directory File and Use 08/22/2011
Section 1 � Introduction This directory provides a list of Amerigroup network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers who are listed in this directory to be your Primary Care P�� you must get your health care coverage from your PCP. Your PCP can also help you arrange or coordinate your covered services. This includes X-rays, laboratory tests, therapies, specialists, hospital admissions, and follow-up care. Your PCP also contacts other plan providers for updates about your care and treatment. Your PCP must give approval ahead of time for certain types of covered services and supplies In some cases, your PCP will need to get prior authorization (prior approval). Since your PCP will provide and coordinate your health care, you should have all of your past medical records sent to you�� network �� care coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. What should you do if you have bills from non-plan providers that you think should be paid by Amerigroup? In some cases, you may get covered services from non-network providers. You can get services from non-network providers without prior approval from your PCP or our plan if you require emergency or urgent care, or if you require dialysis treatment and you are not in our service area. In addition, if you need medical care that Medicare requires our plan to cover and the providers in our network cannot provide this care, you can get this care from an out-of-network provider as long as you get prior approval from our plan. If a non-plan provider asks you to pay for covered services you get in these situations, please call Member Services at 1-866-805-4589 from 8:00 a.m. to 8:00 p.m. local time, 7 days a week. TTY users should call 1-800-855-2880. You can also contact us by mail at: SSO-ALL-0315-11 Reimbursement Claims Amerigroup Member Services P.O. Box 62947 Virginia Beach, VA 23462-2947 The provider has a right to get his or her fees, but does not have a right to get them from you. Ask the non-plan provider to bill us first. If you have already paid for the covered services, we will reimburse you for our share of the cost. If you get a bill for the services, you can send the bill to us for payment (see your Evidence of Coverage for instructions on submitting a bill). We will pay your non-plan provider for our share of the bill, and we will let you know what, if anything, you must pay.
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Primary Care Providers Proveedores
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OTHER PROVIDERS/OTROS PROVEEDORES D
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Introduction This booklet provides
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Pharmacies Farmacias Page/Página 3
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Index of Providers Índice de Prove
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New Mexico Provider and Pharmacy Directory - Amerigroup

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