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Manuals and Forms | Ambetter from Peach State Health Plan
Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2023 Provider and Billing Manual (PDF)
- 2022 Provider and Billing Manual (PDF)
- ICD-10 Information
- Provider Toolkit
- HEDIS MY2022 Quick Reference Guide (PDF)
- Cultural Competency Provider Training
- New Provider Orientation Training
- Information Hour Webinar (PDF)
- 2023 Provider Training (PDF)
Medical Management
- Quarter 1 2022 SB80 Report (PDF)
- Quarter 2 2022 SB80 Report (PDF)
- Quarter 3 2022 SB80 Report (PDF)
- Quarter 4 2022 SB80 Report (PDF)
- Quarter 1 2023 SB80 Report (PDF)
- Pre-Auth Needed?
- Prior Authorization Guide
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievance and Appeals
- Provider Notification of Pregnancy Form (PDF)
Behavioral Health
- Discharge Consultation Form (PDF)
- OTR Completion Tip Sheet (PDF)
- Psychological or Neuropsych Testing Authorization Request Form (PDF)
- Electroconvulsive Therapy (ECT) Authorization Request Form (PDF)
- Intensive Outpatient/Day Treatment Form for Mental Health/Chemical Dependency (PDF)
- Outpatient Treatment Request Form (PDF)
- Behavioral Health HEDIS Provider Toolkit (PDF)
- Suicide Prevention (PDF)
Claims and Claim Payment
Quality
- Quality Improvement Program Results
- Practice Guidelines (PDF)
- Quality Improvement (QI)
- Psychiatric Collaborative Care Model (CoCM) (PDF)