Amerigroup
Amerigroup is a payer organization operating in District of Columbia, Georgia, Maryland, and New Mexico. For an ASC, what matters isn't the logo. It's how Amerigroup pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Amerigroup analysis
Tell us where to send it. Our team will prepare an analysis of Amerigroup covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Amerigroup pays
See how Amerigroup reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Amerigroup's presence spans District of Columbia, Georgia, Maryland, and New Mexico. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Amerigroup and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Amerigroup's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Amerigroup up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Amerigroup
- Payer ID
- 26375 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Amerigroup through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Amerigroup members are verified before the date of service, through a clearinghouse using payer ID 26375or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Amerigroup directly before the date of service.
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A 15-minute walkthrough of Amerigroup the way it pays.
- What is Amerigroup's payer ID?
- Amerigroup's electronic payer ID is 26375. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Amerigroup through a clearinghouse.
- How do ASCs verify eligibility for Amerigroup members?
- Eligibility and benefits for Amerigroup members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 26375) or through the payer's provider portal.
- Does Amerigroup require prior authorization for ASC procedures?
- Prior-authorization requirements for Amerigroup are set per plan and per procedure. Confirm whether an authorization is required with Amerigroup directly before the date of service.
- What type of payer is Amerigroup?
- Amerigroup is a payer organization operating in District of Columbia, Georgia, Maryland, and New Mexico.
- How does Amerigroup compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Amerigroup pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Amerigroup paying my ASC below market?
- Put your own Amerigroup contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.