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 Broker
- 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
- Caregiver Resources
- 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
-
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 Broker
- 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
- Caregiver Resources
- 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
-
Provider Manuals and Forms | Ambetter from Magnolia 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)
- Prior Authorization Guide (PDF)
- Secure Portal (PDF)
- Payspan (PDF)
- ICD-10 Information
- Ambetter Provider Tip Sheet (PDF)
- Adult Wellness Visit Checklist (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
Medical Management
- Pre-Auth-Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Outpatient Treatment Request (OTR) Tip Sheet PDF
- Grievance and Appeals
- Birth Event Notification
Population Health/Behavioral Health
Claims and Claim Payment
- Claim Dispute Form (PDF)
- Taxonomy Code Billing Requirement (PDF)
- Common Claim Reject Errors (PDF)
- Electronic Transactions (EDI) (PDF)
- No Surprises Act Open Negotiation Form (PDF)
Quality
- 2023 Clinical Practice Guidelines (PDF)
- Preventive Health and Clinical Practice Guidelines (PDF)
- Quality Improvement (QI)
- Providing Quality Care
National Imaging Associates (NIA)
- NIA Transthoracic Echocardiography Announcement (PDF)
- Transthoracic Echocardiography (TTE) Guidelines (PDF)
- NIA FAQ (PDF)