Provider Resources

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

Reference Materials

• 2017 Provider and Billing Manual
• Quick Reference Guide
• ICD-10 Information
• Payspan
• Secure Portal
• Wellness and Preventive Services Fact Sheet

Medical Management

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

Prior Authorizations Monthly Data

• June 2015 Inpatient Authorization Statistics
  
• June 2015 Inpatient Authorizations Summary
• June 2015 Outpatient Authorizations Statistics
• June 2015 Outpatient Authorizations Summary
• June 2015 Count of Service Status

Behavioral Health

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

Claims and Claim Payment

• Electronic Transactions
• Claim Dispute Form

Quality

• 2017 HEDIS Guide
• Clinical Practice Guidelines
• Quality Improvement (QI)

Other

• Creating a Cenpatico Secure Portal Account