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Need to Activate Coverage? Pay Premium Now
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
- 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 NH Healthy Families
Provider Resources
Ambetter provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2024 Provider & Billing Manual (PDF)
- 2023 Provider & Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Prior Authorization Guide (PDF)
- Secure Portal (PDF)
- Payspan (PDF)
- ICD-10 Information
- 2024 Ambetter Provider Orientation (PDF)
- CAQH Provider Data Form (PDF)
- Billing Guidelines for Newborn Babies (PDF)
- NIA Physical Medicine Program Provider Training (PDF)
- Provider Change Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?
- Inpatient Authorization Form (PDF)
- Outpatient Authorization Form (PDF)
- Non-OB Ultrasound Authorization Form (PDF)
- Discharge Consultation From (PDF)
- Behavioral Health Provider Specialty Profile (PDF)
- Prescription Fulfillment (PDF)
- Coordination of Care (PDF)
- Collaboration of Care: Medication Management (PDF)
- Transition Planning (PDF)
- Caregiver Training (PDF)
- Functional Behavior Assessments and Behavior Intervention Plans (PDF)
- Applied Behavioral Analysis Prior Authorization Request Form (PDF)
Claims & Claims Payment
- Claim Dispute Form (PDF)
- Explanation of Payment Request (PDF)
- CAH Billing Tip Sheet (PDF)
- Negative Balance Tip Sheet (PDF)
- Provider Negative Balance Request Form (PDF)
- No Surprises Act Open Negotiation Form (PDF)