Don’t delay, enroll in an Ambetter plan today
Manuals & Forms for Providers | Ambetter from Sunflower Health Plan
Ambetter provides the tools and support you need to deliver the best quality of care.
Please contact us with any questions you may have.
- 2020 Provider and Billing Manual (PDF)
- 2021 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- ICD-10 Information
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Resource Guide (PDF)
- Preventive Services Guide (PDF): Member guide with detail about covered preventive services.
- Pre-Auth Needed?
- Prior Authorization Guide (PDF)
- Oncology Pharmacy Authorizations: For members 18 years of age or older, authorizations for oncology-related chemotherapeutic drugs and supportive agents are administered by New Century Health.
- Electroconvulsive Therapy Authorization Form (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Intensive Outpatient/Day Treatment Authorization Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Outpatient Treatment Request Form (PDF)
- Psychological or Neuropsych Testing Authorization Form (PDF)
- Provider Fax Back Form (PDF)
- Applied Behavioral Analysis Authorization Form (PDF)
- Birth Event Notification (PDF): Optional form to report birth events/outcomes.