New Mexico Provider and Pharmacy Directory - Amerigroup

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�������������������
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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.