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Ambetter provides the tools and support you need to deliver the best quality of care.
- 2019 Provider and Billing Manual (PDF)
- Provider Manual Addendum (PDF)
- Prior Authorization Guide (PDF)
- Payspan (PDF)
- Quick Reference Guide (PDF)
- Secure Portal (PDF)
- Provider Expedited Certification (PDF)
- Appeal Request Form (PDF)
- Pre-Auth needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Prior Authorization Request Form for Non-Specialty Drugs (PDF)
- Prior Authorization Request Forms for Specialty Drugs
- Grievance and Appeals