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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
- 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 and Forms for Providers | Ambetter from Absolute Total Care
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)
- Provider Portal Enhancements: Claim Reconsideration and Denial Explanations (PDF)
- Provider Town Hall (PDF)
- No Surprises Act Open Negotiation Form (PDF)
- Ambetter Provider Claim Reconsideration/Dispute Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
Medical Management/Behavioral Health
- Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF) - Do NOT use for medication request - Effective 03/20/2024
- Supplemental Prior Authorization Fax Form (PDF)
- Notification of Pregnancy (NOP) Form (PDF)
- Discharge Planner Checklist (PDF)
- Pharmacy Forms
Quality
- Quality Improvement (QI) Program
- Practice Guidelines
- Culturally and Linguistically Appropriate Services (CLAS) (PDF)
- Providing Quality Care
National Imagine Associates (NIA)
Provider Training
- Ambetter Provider Education and Training (PDF)
- A Physician’s Practical Guide to Culturally Competent Care
- Provider Training Attestation (PDF)