NEW MEMBER? MAKE YOUR FIRST PAYMENT TO LOCK IN COVERAGE
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NEW MEMBER? MAKE YOUR FIRST PAYMENT TO LOCK IN COVERAGE
Main Menu
-
Our Health Plans
show Our 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
- Health Savings Account
- Better Health Center
- Member News
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 Meridian
Provider Resources
Ambetter Health provides the tools and support you need to deliver the best quality of care.
Provider Relations Inquiry Form
Reference Materials
- 2025 Provider and Billing Manual (PDF)
- 2024 Provider and Billing Manual (PDF)
- Member Notification of Pregnancy (PDF)
- Notification of Pregnancy Form (PDF)
- Well-Being Survey (PDF)
- Prior Authorization Request Form for Prescription Drugs (PDF)
- ICD-10 Information
- Practice Guidelines (PDF)
- No Surprises Act Open Negotiation Form (PDF)
- Diabetes Care Form (PDF)
- Prenatal and Postpartum Care (PDF)
- Women’s Care Form (PDF)
- Well-Care Visits Form (PDF)
- Annual Care for Older Adults (COA) Form (PDF)
- Providing Quality Care
- 2024 Provider Orientation (PDF)
- Navigating the Member ID Card (PDF)
Medical Management/ Behavioral Health
- Inpatient Authorization Form (PDF)
- Outpatient Authorization Form (PDF)
- Clinical Policy: Brand Name Override and Non-Formulary Medications (PDF)
- Biopharmacy Outpatient Prior Authorization Fax Form (PDF)
- Provider Request for Reconsideration and Claim Dispute Form (PDF)
- Prior Authorization Request Form for Non-Specialty Drugs (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Discharge Planner Checklist (PDF)