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Main Menu
-
Our Health Plans
show Our Health Plans menu
-
- About Our Plans
- Our Benefits
- My Health Pays Rewards®
- Coverage Area Map
- Ways to Save
- What is Ambetter Health?
- Shop and Compare Plans
- Find a Doctor
Use your ZIP Code to find your personal plan.
- See coverage in your area
- Find doctors and hospitals
- View pharmacy program benefits
- View essential health benefits
Find and enroll in a plan that's right for you.
-
-
Join Ambetter Health
show Join Ambetter Health menu
-
- Four easy steps is all it takes
- What you need to enroll
- Special Enrollment Information
-
-
For Members
show For Members menu
-
- Pay Now
- Find a Doctor
- Drug Coverage
- Forms and Materials
- Ways to Pay
- New Members
- Renew Your Plan
- Better Health Center
- The Better Bulletin
- Member News
- Medicare Eligible
- Health Savings Account
Find everything you need in the member online account
- View your claims
- Review your plan benefits
- Print your ID card
- View rewards points total
-
Manuals & Forms for Providers | Ambetter from MHS Indiana
Provider Resources
Change Healthcare Outage
If you are impacted by the Change Healthcare outage, please visit the Provider News page for further information.
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2024 Provider and Billing Manual (PDF)
- 2023 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)
Forms
- Ambetter/Wellcare Practitioner Enrollment Form (PDF)
- Behavioral Health Provider Specialty Form (PDF)
- Behavioral Health Facility and Ancillary Demographic Form (PDF)
- IHCP/Ambetter/Wellcare Ancillary Enrollment Form (PDF)
- Provider Credentialing Application Disability Supplement Form (PDF)
- Non-Contracted Provider Set Up Form
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)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Practicioner Enrollment Form (PDF)
Claims and Claim Payment
Quality
- Practices Guidelines (PDF)
- 2023 HEDIS Quick Reference Guide (PDF)
- Quality Improvement (QI)
- Providing Quality Care