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Provider Manuals and Forms | Ambetter from Magnolia Health
Provider Resources
Coronavirus (COVID-19)
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2022 Provider and Billing Manual (PDF)
- 2020 Provider and Billing Manual (PDF)
- 2021 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Secure Portal (PDF)
- Payspan (PDF)
- ICD-10 Information
- Ambetter Provider Tip Sheet (PDF)
- Adult Wellness Visit Checklist (PDF)
Medical Management
- Pre-Auth-Needed?
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievance and Appeals
- Birth Event Notification
Population Health/Behavioral Health
Claims and Claim Payment
- Claim Dispute Form (PDF)
- Taxonomy Code Billing Requirement (PDF)
- Common Claim Reject Errors (PDF)
- Electronic Transactions (EDI) (PDF)
- No Surprises Act Open Negotiation Form (PDF)
Quality
- 2022 Clinical Practice Guidelines (PDF)
- Preventive Health and Clinical Practice Guidelines (PDF)
- Quality Improvement (QI)
National Imaging Associates (NIA)
