Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Click here to view our schedule of upcoming Provider trainings.
Reference Materials
- 2018 Provider & Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Secure Portal (PDF)
- Payspan (PDF)
- Provider Training (PDF)
- ICD-10 Information
Medical Management
- Pre-Auth Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievance and Appeals
- Biopharmacy Outpatient Prior Authorization Form (J-code products) (PDF)
Behavioral Health
- Discharge Consultation Documentation Fax Form (PDF)
- Inpatient Electroconvulsive Therapy (ECT) Request Form (PDF)
- Outpatient Electroconvulsive Therapy (ECT) Request Form (PDF)
- Outpatient Treatment Request Form (PDF)
- Intensive Outpatient Treatment Form (PDF)
- Psychological or Neuropsych Testing Inpatient Authorization Request Form (PDF)
- OTR Completion Tip Sheet (PDF)
Claims and Claim Payment
Quality