Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2018 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- ICD-10 Information
- Payspan (PDF)
- Secure Portal (PDF)
- Wellness and Preventive Services Fact Sheet (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
Prior Authorizations Monthly Data
- June 2015 Inpatient Authorization Statistics (PDF)
- June 2015 Inpatient Authorizations Summary (PDF)
- June 2015 Outpatient Authorizations Statistics (PDF)
- June 2015 Outpatient Authorizations Summary (PDF)
- June 2015 Count of Service Status (PDF)
Behavioral Health
- Discharge Consultation 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)
- OTR Tip Sheet (PDF)
- Psychological or Neuropsych Testing Authorization Request Form (PDF)
Claims and Claim Payment
Quality
- HEDIS Guide (PDF)
- Clinical Practice Guidelines
- Cultural Comptency Plan (PDF)
- LBP & AAB (PDF)
- Pay for Performance (P4P) HEDIS Quick Reference Guide (PDF)
- Quality Improvement (QI)
Provider Credentialing
Attention
If you would like to become a provider within our network, please fill out the Become A Provider form. Or call us at 1-844-631-6830 or by emailing ArkansasContracting@centene.com.