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Manuals & Forms for Providers | Ambetter from Arkansas Health & Wellness
Provider Resources
Ambetter Health provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2025 Provider and Billing Manual (PDF)
- 2024 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- ICD-10 Information
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Portal Initiative FAQ (PDF)
- Ambetter Reimburses for Substance Use Services (PDF)
- Long-Acting Medications as First-Line Treatment in Schizophrenia (PDF)
- Provider Data Change Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Opioid Resources for Prescribers
- Adult Immunization (PDF)
- METS (Members Empowered to Succeed) (PDF)
- METS Frequently Asked Questions (PDF)
- Remittance Advice/Explanationof Payment (EOP) Guide (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Supplemental Outpatient Prior Authorization Form (PDF)
- Grievance and Appeals
- Discharge Consultation Form (PDF)
- Discharge Planner Checklist (PDF)
- Turning Point Prior Authorization
- Benefit Inquiry Form (PDF)
Claims and Claim Payment
Quality
- Practice Guidelines (PDF)
- Cultural Competency Plan (PDF)
- Quality Improvement (QI)
- Ambetter Member Reassignment Form (PDF)
- Providing Quality Care
- Diabetic Care Coordination (PDF)
Other
Provider Credentialing
Attention
If you would like to become a provider within our network, please fill out the Become a Provider form. Or call us at 1-844-631-6830 or by emailing ArkansasContracting@centene.com.
- Allied and Advance Practice Nurse Credentialing Application (PDF)
- Medical Doctor or Doctor of Osteopathy Credentialing Application (PDF)