Ambetter Health HH/DME Outpatient Prior Authorization Request Guide

Date: 06/30/25

Ambetter Health wants to help Home Health (HH) and Durable Medical Equipment (DME) providers quickly submit outpatient Prior Authorization (PA) requests for our members. We have updated the quick reference guide that helps you through this process.

Download: Ambetter HH/DME Prior Authorization QRG (PDF)

Resources for Home Health Providers

We created an online resource to help HH/DME providers address all their issues. You’ll find the reference guides, forms and information you need.

Visit: SunshineHealth.com/home-health

Questions?

Ambetter Health has a wealth of resources available to help answer your questions and address your concerns:

• Provider Services: Call 1-877-687-1169
• Secure Provider Portal: Visit Provider.SunshineHealth.com to check member eligibility, submit claims and more.
• Provider Engagement: Use the Find Your Account Manager tool to find the Provider Engagement Account Manager (PEAM) supporting your specialty and region.
• Provider News: Bookmark Ambetter Health Provider News and Sunshine Health Provider News to keep up with the latest updates.
• Provider Newsflash: Subscribe to our e-newsletter to get regular updates.
• Provider Resources: Visit Ambetter Health Provider Resources to find provider manuals, important forms, scheduling standards and other provider resources.
• Provider Resources: Visit AmbetterHealth.com/flprovider to find provider manuals, important forms, scheduling standards and other resources.