HAVE AN ENROLLMENT NEED? SHOP OUR PLANS
Handbooks & Forms for Members | Ambetter from Arkansas Health & Wellness
Member Resources
Many of our member resources, such as the member handbook and forms, can be found by logging into your online member account. Click Login to create an account and access a wide array of resources!
Quick Reference Guide (QRG)
Reference Materials
- Auto Bill Pay Terms and Conditions (PDF)
- Dr. Office Visit Checklist (PDF)
- Get Your Flu Shot
- Preventive Services Guide (PDF)
- Primary Care Physician Visit Checklist (PDF)
- Quality Improvement (QI) Program
- Statement of Non-Discrimination
- Balance Billing Disclosures
- 2024 Transparency Notice
- 2023 Transparency Notice
- Where To Go For Care
- Women's Health and Cancer Rights Act Annual Notice
- Ambetter In-Network Hemophilia Pharmacies
- Interoperability and Patient Access
- Cost Comparison Tool
- Wellness and Health Information
- My Asthma Management Guide (PDF)
- PCMH Practitioners List (PDF)
- The patient-centered medical home (PCMH) is a model of care that places patients at the center of their care journeys, enhancing the level of care they receive by transforming how it is organized and delivered. According to the Centers for Disease Control and Prevention (CDC), this model has been shown to improve chronic disease management, patient and provider satisfaction, and preventive care efforts. It has also been shown to increase cost savings and improve the overall quality of care that patients receive. Providers that are recognized as PCMHs are committed to continuous quality improvement with patients as the primary focus.
- FindHelp.org
- Use FindHelp to get access to resources near you
Forms
- Authorization to Disclose Health Information Form (PDF)
- Grievance, Appeal, Concern or Recommendation Form (PDF)
- Member Reimbursement Medical Claim Form (PDF)
- Dental Member Reimbursement Form (PDF)
- Prescription Claim Reimbursement Form (PDF)
- Revocation of Authorization to Disclose Health Information (PDF)
- Donor Travel Reimbursement Form (PDF)
- Recipient Travel Reimbursement Form (PDF)
- Member Transplant Travel Reimbursement Policy (PDF)
- Authorization Representative Designation Form (PDF)
Educational Materials
- Mental Health Follow-Up (PDF)
- Antidepressants Adherence (PDF)
- Colorectal Cancer (PDF)
- Admitted to the Hospital (PDF)
- Coping with Anxiety (PDF)
- How Buprenorphine Can Help with Pain and Opioid Addiction (PDF)
- Getting Help for Opioid Use Disorder and Opioid Addiction (PDF)
- What to Do During an Opioid Overdose (PDF)
- How to Keep You and Your Loved Ones Safe when Using Pain Medication (PDF)
- My Wellness Checklist (PDF)
- Long-Acting Medicines (PDF)
- What to Do During Your Pregnancy (PDF)
- Use 988 to Connect to the National Suicide Prevention Lifeline (PDF)
- Managing Heart Failure and Prevention of Hospital Admission (PDF)
- Asthma Medication Ratio: Ages 19–64 (AMR) (PDF)
- COPD Management (PDF)