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Provider Resources | Ambetter from Peach State Health Plan
Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Add plan specific forms and manuals here
Reference Materials
- 2020 Provider and Billing Manual (PDF)
- ICD-10 Information
- Quick Reference Guide (PDF)
- Payspan (PDF)
- Secure Portal (PDF)
Medical Management
- Pre-Auth Needed?
- Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievance and Appeals
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)
Claims and Claim Payment
Quality
Other
