Ambetter provides the tools and support you need to deliver the best quality of care.

Reference Materials

• 2019 Provider & Billing Manual (PDF)
• 2020 Provider & Billing Manual (PDF)
• Quick Reference Guide (PDF)
• ICD-10 Information
• Payspan (PDF)
• Secure Portal (PDF)
• Cultural Competency (PDF)

Medical Management/Behavioral Health

• Prior Authorization Guide (PDF)
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)
• Grievance and Appeals
• Prior Authorization Request Form for Non-Specialty Drugs (PDF)

Quality

• Quality Improvement (QI) Program
• Practice Guidelines