Provider Resources

Ambetter provides the tools and support you need to deliver the best quality of care.

Reference Materials

• 2017 Provider and Billing Manual
• ICD-10 Information
• Quick Reference Guide
• Payspan
• Secure Portal

Medical Management

• Pre-Auth Needed?
• Prior Authorization Guide
• Inpatient Prior Authorization Fax Form
• Outpatient Prior Authorization Fax Form
• Authorization and Coverage Complaints

Behavioral Health

• Discharge Consultation Form
• OTR Completion Tip Sheet
• Psychological or Neuropsych Testing Authorization Request Form
• Electroconvulsive Therapy (ECT) Authorization Request Form
• Intensive Outpatient/Day Treatment Form for Mental Health/Chemical Dependency
• Outpatient Treatment Request Form

Claims and Claim Payment

• Claim Dispute Form
• Ambetter Taxonomy Guide

Quality

• Quality Improvement Program Results
• 2016 HEDIS Quick Reference Guide
• Clinical Practice Guidelines
• Quality Improvement (QI)

Other

• Covered Services and Authorization Grid
• Creating a Cenpatico Secure Portal Account
• Provider Relations Territory List