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NEED HEALTH INSURANCE? SHOP OUR PLANS.External Link
Manuals & Forms for Providers | Ambetter from Meridian
Provider Resources
Ambetter Health provides the tools and support you need to deliver the best quality of care.
Provider Relations Inquiry Form
Reference Materials
- 2025 Provider and Billing Manual (PDF)
- 2024 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Pharmacy Guide (PDF)
- Claims, Disputes & Recovery/CCU Guide (PDF)
- Appeals/Reconsiderations (Medical) And Grievances Guide (PDF)
- Member Notification of Pregnancy (PDF)
- Notification of Pregnancy Form (PDF)
- Well-Being Survey (PDF)
- Prior Authorization Request Form for Prescription Drugs (PDF)
- ICD-10 InformationExternal Link
- Practice Guidelines (PDF)
- No Surprises Act Open Negotiation Form (PDF)
- Diabetes Care Form (PDF)
- Prenatal and Postpartum Care (PDF)
- Women’s Care Form (PDF)
- Well-Care Visits Form (PDF)
- Annual Care for Older Adults (COA) Form (PDF)
- Providing Quality Care
- 2024 Provider Orientation (PDF)
- Navigating the Member ID Card (PDF)
- International Normalizing Ratio Monitoring for Individuals on Warfarin (INR) (PDF)
Medical Management/ Behavioral Health
- Inpatient Authorization Form (PDF)
- Outpatient Authorization Form (PDF)
- Clinical Policy: Brand Name Override and Non-Formulary Medications (PDF)
- Biopharmacy Outpatient Prior Authorization Fax Form (PDF)
- Provider Request for Reconsideration and Claim Dispute Form (PDF)
- Prior Authorization Request Form for Non-Specialty Drugs (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Discharge Planner Checklist (PDF)