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Manuals & Forms for Providers | Ambetter from PA Health & Wellness
Ambetter provides the tools and support you need to deliver the best quality of care.
- 2020 Provider & Billing Manual (PDF)
- 2021 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- ICD-10 Information
- Payspan (PDF)
- Secure Portal (PDF)
Medical Management/ Behavioral Health
- Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievances & Appeals
- Prior Authorization Request Form for Non-Specialty Drugs (PDF)