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NEW MEMBER? MAKE YOUR FIRST PAYMENT TO LOCK IN COVERAGE
Main Menu
-
Indiana Health Plans
show Indiana Health Plans menu
-
- About Our Plans
- Our Benefits
- 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 & Forms for Providers | Ambetter from MHS Indiana
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)
- ICD-10 Information
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Newsletters
- Provider Network Guide (PDF)
- Home Health Filing Guidelines (PDF)
Forms
- Ambetter/Wellcare Practitioner Enrollment Form (PDF)
- Behavioral Health Provider Specialty Form (PDF)
- Behavioral Health Facility and Ancillary Demographic Form (PDF)
- IHCP/Ambetter/Wellcare Ancillary Enrollment Form (PDF)
- Provider Credentialing Application Disability Supplement Form (PDF)
- Non-Contracted Provider Set Up Form
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Fillable Prior Authorization Form (PDF)
- Grievance and Appeals
- Clinical Practice and Preventive Health Guidelines (PDF)
- Outpatient to ASC Prior Authorization by County (PDF)
- Discharge Consultation Form (PDF)
- Discharge Planner Checklist (PDF)
- SMART Goals Fact Sheet (PDF)
- ABA Prior Authorization Request Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Practicioner Enrollment Form (PDF)
Claims and Claim Payment
Quality
- Practices Guidelines (PDF)
- 2024 HEDIS Quick Reference Guide (PDF)
- Quality Improvement (QI)
- Providing Quality Care