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SAVE TIME FOR THE THINGS YOU LOVE. ENROLL IN AUTO PAY TODAY.
Main Menu
-
Our Health Plans
show Our Health Plans menu
-
- About Our Plans
- Programs & Perks
- My Health Pays Rewards®
- Coverage Area Map
- Ways to Save
- What is Ambetter Health?
- Shop and Compare Plans
- Find a Doctor
Use your ZIP Code to find your personal plan.
- See coverage in your area
- Find doctors and hospitals
- View pharmacy program benefits
- View essential health benefits
Find and enroll in a plan that's right for you.
-
-
Join Ambetter Health
show Join Ambetter Health menu
-
- Four easy steps is all it takes
- What you need to enroll
- Special Enrollment Information
-
-
For Members
show For Members menu
-
- Pay Now
- Find a Doctor
- Drug Coverage
- Forms and Materials
- Ways to Pay
- New Members
- Renew Your Plan
- Better Health Center
- Member News
- Health Savings Account
Find everything you need in the member online account
- View your claims
- Review your plan benefits
- Print your ID card
- View rewards points total
-
Manuals and Forms | Ambetter from Peach State Health Plan
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)
- Appeals/Reconsiderations (Medical) And Grievances Guide (PDF)
- ICD-10 Information
- Provider Toolkit
- HEDIS MY2022 Quick Reference Guide (PDF)
- Cultural Competency Provider Training
- New Provider Orientation Training
- Information Hour Webinar (PDF)
- 2023 Provider Training (PDF)
- 2024 Provider Training (PDF)
- January 2024 Provider Information Hour Webinar (PDF)
- 2025 Ambetter Quick Reference Guide (PDF)
- The Supplemental Data Journey (PDF)
- Supplemental Data System Submission Process (PDF)
- Information Hour Webinar February 2025 (PDF)
Medical Management
- Quarter 1 2022 SB80 Report (PDF)
- Quarter 2 2022 SB80 Report (PDF)
- Quarter 3 2022 SB80 Report (PDF)
- Quarter 4 2022 SB80 Report (PDF)
- Quarter 1 2023 SB80 Report (PDF)
- Quarter 2 2023 SB80 Report (PDF)
- Quarter 3 2023 SB80 Report (PDF)
- Quarter 4 2023 SB80 Report (PDF)
- Quarter 1 2024 SB80 Report (PDF)
- Quarter 2 2024 SB80 Report (PDF)
- Quarter 3 2024 SB80 Report (PDF)
- Quarter 4 2024 SB80 Report (PDF)
- Quarter 1 2025 SB80 Report (PDF)
- Pre-Auth Needed?
- Prior Authorization Guide
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Supplemental Fax Form (PDF)
- Grievance and Appeals
- Provider Notification of Pregnancy Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
Behavioral Health
- Discharge Consultation Form (PDF)
- Discharge Planner Checklist (PDF)
- OTR Completion Tip Sheet (PDF)
- Behavioral Health HEDIS Provider Toolkit (PDF)
- Suicide Prevention (PDF)
Behavioral Health and Quality
- Coordination Of Care (PDF)
- Discharge PlannerChecklist (PDF)
- Microlearning Strategies (PDF)
- Improving Patient Engagement In Behavioral Healthcare (PDF)
- Cahps® Experience Of Care And Health Outcomes (ECHO) Survey (PDF)
- Primary Care Provider (PCP)/Behavioral Health (BH) Provider Communication Form (PDF)
- Reducing The Stigma Surrounding Mental Illness (PDF)
- Quality Rating System (QRS) Behavioral Health Measure Toolkit (PDF)
Claims and Claim Payment
- Claims, Disputes & Recovery/CCU Guide (PDF)
- Claim Dispute Form (PDF)
- Ambetter Taxonomy Guide (PDF)
- No Surprises Act Open Negotiation Form (PDF)
Quality
- Quality Improvement Program Results
- Practice Guidelines (PDF)
- Quality Improvement (QI)
- Psychiatric Collaborative Care Model (CoCM) (PDF)
- Providing Quality Care