Amerigroup Customer Service: phone numbers, processes, and best practices

Primary contact channels and official resources

The fastest way to reach Amerigroup customer service is to call the Member Services number printed on your member ID card; that number routes directly to representatives who can access your plan, benefits, claims, and authorization records. Amerigroup’s public website — https://www.amerigroup.com — hosts plan-specific contact pages, provider portals, downloadable forms and secure messaging for many members. If you are a Medicare beneficiary and need federal assistance, you can also call Medicare at 1-800-633-4227 (TTY 711) for help with Medicare-related issues and cross‑checks.

Typical operating patterns for Amerigroup phone centers vary by state and plan. Non-urgent Member Services lines for most commercial and Medicaid plans are staffed Monday–Friday and often during extended weekday hours (for many plans approximately 8:00 a.m.–8:00 p.m. local time); urgent clinical matters and certain behavioral-health or pharmacy lines may be staffed 24/7. If you need TTY or relay service, use TTY 711 and follow the operator instructions; Amerigroup also provides interpreter services for more than 200 languages on request.

What to prepare before you call

Having the right documentation and details ready will cut hold time and speed resolution. At minimum, have the member ID number (from the front of the ID card), the member’s full name and date of birth, the provider name, the date(s) of service, and any claim or authorization numbers. If you expect the representative to look up a claim, have the provider’s tax ID or NPI and the billed amount available; that allows cross-referencing within Amerigroup’s claims system and avoids call transfers.

Do not provide your full Social Security Number on an open call unless specifically requested by the secure representative; many plans will accept the last four digits for verification. If you are calling about an appeal or grievance, bring the denial letter date, specific CPT or HCPCS codes in question, and any clinical notes or physician letters that support medical necessity. If possible, upload those documents to the secure member portal prior to or during your call and ask the representative to attach them to the case.

• Essentials to have: member ID number, date of birth, provider name and date(s) of service, claim/authorization number, billed amount, last 4 digits of SSN (if needed), and any supporting clinical documentation or physician letters.

Common reasons people call and how Amerigroup handles them

Members most frequently call about (1) benefits and coverage questions (copays, prior authorization requirements, whether a service is in-network), (2) claims status and reimbursements, (3) pharmacy formulary and prior authorization for medications, and (4) behavioral health and case management referrals. Amerigroup routes calls to specialized queues—pharmacy, utilization management, behavioral health, and provider relations—so expect a transfer for technical issues. Many plans now show real-time claim status in the member portal; when a call is necessary, reference the claim number to reduce lookup time.

When a medical necessity or coverage denial occurs, Amerigroup typically creates a written Explanation of Benefits (EOB) or denial notice which details the reason and the next steps for appeal or grievance. Internal appeal timetables differ by program, but insurers commonly process standard non-urgent appeals within roughly 30 calendar days and expedited or urgent requests within 72 hours; always confirm the exact deadlines printed on your denial notice so you do not miss appeal windows. For Medicare-related denials you may have separate CMS timelines and escalation options.

Escalation paths, grievances, appeals and external review

If Member Services cannot resolve your issue on first contact, request escalation to a supervisor and ask for a case/reference number and an expected response date. For formal grievances and appeals, Amerigroup provides written forms on amerigroup.com and via the member portal; submit supporting clinical documentation and request confirmation of receipt (reference number and the staff member who accepted it). For many plans, the appeals process begins with an internal review and, if denied, can progress to an external independent review by a state or federal reviewer.

External review options depend on your plan type: Medicaid beneficiaries generally use state fair-hearing processes and state insurance regulators; Medicare Advantage enrollees may use the Medicare independent review or file complaints via 1-800-MEDICARE (1-800-633-4227). Typical external review filing windows are measured in months (commonly 4 months/120 days from denial), but these vary—verify the precise deadline on your denial letter and on the Amerigroup appeals page. If you plan to submit an appeal, consider sending documentation both electronically through the portal and by certified mail so you have delivery records.

Provider services, pharmacy prior authorization, and specialized lines

Providers should use Amerigroup’s dedicated provider portal and provider relations phone lines (numbers are plan- and state-specific and appear on the provider website). Prior authorization for high-cost imaging, durable medical equipment, specialty drugs and certain procedures typically requires a pre-service review; allow 7–14 business days for routine medical necessity reviews and request an expedited review if treatment delay would jeopardize health. For specialty pharmacy prior auths, have the NDC or drug name, diagnosis code and prior trial documentation available.

Behavioral health, case management and social-service referrals are often handled by separate clinical teams within Amerigroup. If your call involves discharge planning, complex care coordination, or home- and community-based services, request transfer to case management and ask for the manager’s name and a care-plan timeline. For time-sensitive behavioral health crises, use the dedicated Behavioral Health crisis number listed on your ID card or call local emergency services if there is immediate danger.

Practical tips to reduce hold time and get faster resolutions

Follow these practical steps to shorten calls and improve outcomes. Call early in the morning (first hour after opening) or mid-week to avoid peak volume; use secure online messaging or the member portal for document uploads and non-urgent questions—these channels often produce a written case note and a faster turnaround than repeated phone calls. Always request and write down the representative’s name, case/reference number, and the expected follow-up date.

• If you need external help: Medicare help line 1-800-633-4227 (TTY 711); state Medicaid consumer assistance contact is listed on your state’s Medicaid website. Keep certified-mail records for appeals and ask for written confirmations for any verbal approvals.

Sample phone script

“Hello, my name is [Your Name], I am calling about member [Member Name], DOB [MM/DD/YYYY], member ID [########]. I am calling regarding claim #[########] for [provider name] dated [date of service]. The claim was denied for [reason on EOB]. I would like to open an appeal and attach clinical documentation. Can you confirm the internal appeal deadline, the department handling appeals, and provide a case/reference number?”

Use that script to keep the call focused, avoid repeating information, and prompt the representative to provide specific next steps. If the issue is clinical, ask for escalation to utilization management or clinical review and request written confirmation of the outcome and timelines.