NEW MEMBER? MAKE YOUR FIRST PAYMENT TO LOCK IN COVERAGE
Skip to Main Content
-
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
- 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
-
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
- 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
-
Provider Manuals and Forms | Ambetter from Home State Health
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)
- Ambetter Taxonomy (PDF)
- Hemophilia Network Posting
- TurningPoint Healthcare Solutions
- In-Home Test Kits (PDF)
- No Surprises Act Open Negotiation Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Spine Surgery - Evolent Utilization Matrix (PDF)
- Joint Surgery - Evolent Utilization Matrix (PDF)
- NIA Utilization Matrix (PDF)
- Clean Claim Vendor FAQs (PDF)
- Evolent Cardiology Solutions FAQs (PDF)
- Availity Editing Services (PDF)
- Transitions to Availity Essentials (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Provider Fax Back Form (PDF)
- MO Marketplace Out of Network Form (PDF)
- Ambetter from Home State Health Oncology Pathway Solutions FAQs (PDF)
- National Imaging Associates, Inc. FAQs (PDF)
- Physical Medicine Prior Authorization QRG - NIA (PDF)
- Discharge Planner Checklist (PDF)
Quality
- Quality Improvement (QI)
- Practice Guidelines (PDF)
- Controlling High Blood Pressure Coding Sheet (PDF)
- HEDIS 2021 QRG (PDF)
- Providing Quality Care
Opioid Toolkit
Summary Guidelines
Pain Management and Opioid Online Training
Fluvention
Other
- Provider Reconsideration and Appeal Request Form (PDF)
- CoverMyMeds Guide (PDF)
- Update and Certify Provider Data in CMS's NPPES (PDF)
- Centene Vision Services
- Centene Dental Services