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Manuals & Forms for Providers | Ambetter from MHS Indiana
Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2023 Provider and Billing Manual (PDF)
- 2022 Provider and Billing Manual (PDF)
- ICD-10 Information
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Newsletters
- Provider Network Guide (PDF)
- Home Health Filing Guidelines (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Fillable Prior Authorization Form (PDF)
- Grievance and Appeals
- Clinical Practice and Preventive Health Guidelines (PDF)
- Outpatient to ASC Prior Authorization by County (PDF)
- Discharge Consultation Form (PDF)
- SMART Goals Fact Sheet (PDF)
- ABA Prior Authorization Request Form (PDF)