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  • HealthPlan ID Cards

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    Martin Mwendwa
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    This document is an example of an Amerigroup member ID card. It contains the member's name, ID number, effective date, primary care provider information, and important contact numbers for medical care, preauthorizations, billing inquiries and more. Members are instructed to carry this card at all times and present it before receiving medical care, except in emergencies.

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    HealthPlan_ID_cards

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    This document is an example of an Amerigroup member ID card. It contains the member's name, ID number, effective date, primary care provider information, and important contact numbers for medical care, preauthorizations, billing inquiries and more. Members are instructed to carry this card at all times and present it before receiving medical care, except in emergencies.

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    © All Rights Reserved
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    23 views1 page

    HealthPlan ID Cards

    Uploaded by

    Martin Mwendwa
    This document is an example of an Amerigroup member ID card. It contains the member's name, ID number, effective date, primary care provider information, and important contact numbers for medical care, preauthorizations, billing inquiries and more. Members are instructed to carry this card at all times and present it before receiving medical care, except in emergencies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Example of Amerigroup ID Card

    Effective Date: MDYEFF MEMBERS: Please carry this card at all times. Show this card before you get medical care. You do
    not need to show this card before you get emergency care. If you have an emergency, call 911 or

    ÌX01509100001NÎ
    Date of Birth: MDYDOB go to the nearest emergency room. Always call your Amerigroup PCP for non-emergency care.
    Subscriber #: MEMBERID If you have questions, call Member Services at 1-800-600-4441. If you are hearing impaired,
    please call 1-800-855-2880.
    MIEMBROS: Favor de llevar esta tarjeta con usted en todo momento. Presente esta tarjeta antes
    de recibir atención médica. No tiene que presentarla para recibir atención de emergencia. Si tiene
    una emergencia, llame al 911 ó vaya a la sala de emergencia más cercana. Llame siempre a su
    Member Name: MBRNAME PCP de Amerigroup para atención que no sea de emergencia. Si tiene preguntas, llame a
    Servicios para Miembros al 1-800-600-4441. Si tiene problemas de audicón, favor de llamar al
    1-800-855-2884.
    Medicaid or PeachCare for Kids Number: MBRALTKEY HOSPITALS: Preadmission certification is required for all nonemergency admissions, including

    X01509100001
    Primary Care Provider (PCP): PCPNAME outpatient surgery. For emergency admissions, notify Amerigroup within 24 hours after treatment
    at 1-800-454-3730.
    PCP Telephone #: PCPPHONE PROVIDERS: Certain services must be preauthorized. Care that is not preauthorized may not be
    PCP After Hours #: CLINICPHONE covered. For preauthorizations/billing or pharmacy information, call 1-800-454-3730.
    PCP Address: PCP_ADDRESS_LINE1 PCP_ADDRESS_LINE2 PHARMACIES: Submit claims using Caremark RXBIN: 004336; RXPCN: ADV; RXGRP: RX4284.
    For technical help, call Caremark at 1-800-364-6331.
    Copays may apply for certain services (Medicaid only)
    Vision: 1-866-522-5923 SUBMIT MEDICAL CLAIMS TO:
    Dental: 1-800-608-9563 AMERIGROUP • P.O. BOX 61010 • VIRGINIA BEACH, VA 23466-1010
    AMERIGROUP Member Services/Nurse HelpLine and Behavioral Health USE OF THIS CARD BY ANY PERSON OTHER THAN THE MEMBER IS FRAUD.
    GA01 10/11
    (24 hours a day, 7 days a week): 1-800-600-4441

    Example of WellCare ID Card

    Provider Services Toll Free: 1.800.952.6674 www.av es is .c om

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