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
- 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 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 Buckeye Health Plan
Provider Resources
Ambetter Health provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2025 Provider & Billing Manual (PDF)
- 2024 Provider & Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Prior Auths Removed 3-31-21 (PDF)
- Secure Portal (PDF)
- Payspan (PDF)
- ICD-10 Information
- Electronic Transactions (PDF)
- Ambulatory Surgery Center Optimization Codes (PDF)
- NIA Physical Medicine Request Checklist (PDF)
- NIA Physical Medicine Services FAQs (PDF)
- NIA Expanded Partnership Provider Letter (PDF)
- National Imaging Associates, Inc. (NIA)’s Peer-to-Peer Process (PDF)
- Ambetter Prior Authorization Changes - Effective 10/01/2021 (PDF)
- Ambetter Prior Authorization Change Notification Changes Effective 11/1/21 (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- 2023 Provider Orientation (PDF)
- RSV Flyer (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- CDMS Barcoded Form Disclosure (PDF)
- Grievance and Appeals
- BH - Discharge Consultation Form (PDF)
- BH - SMART Goals Fact Sheet (PDF)
- Discharge Planner Checklist (PDF)
Claims and Claim Payment
Quality
- Practice Guidelines (PDF)
- Quality Improvement (QI)
- Notification of Pregnancy Form (PDF)
- Providing Quality Care