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Member Materials and Forms | Ambetter from MHS
Many of our member resources, such as the member handbook and forms, can be found on our secure portal. Click Login to create an account and access a wide array of resources!
- Doctor's Office Visit Checklist (PDF) - Use this checklist to get prepared for your next doctor's appointment.
- Find a Provider Guide (PDF)
- Get Your Flu Shot
- Preventive Services Guide (PDF)
- Quality Improvement (QI) Program
- Referral and Authorization Information
- Statement of Non-Discrimination
- 2020 Transparency Notice
- 2019 Transparency Notice
- Where To Go For Care
- Women's Health and Cancer Rights Act Annual Notice
- Authorization to Disclose Health Information Form (PDF)
- Grievance and Appeals Form (PDF)
- Member Reimbursement Medical Claim Form (PDF) - Used to submit a paid claim for Out of Country emergency services received from an out-of-network international provider.
- Prescription Claim Reimbursement Form (PDF)
- Transplant Reimbursement Form (PDF)