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Welcome, member! Pay your premium to keep the 2024 coverage you deserve. Pay 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?
- 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
-
Find everything you need in the member online account
- View your claims
- Review your plan benefits
- Print your ID card
- View rewards points total
-
Provider Manuals & Forms | Ambetter from Nebraska Total Care
Provider Resources
Ambetter Health provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2024 Provider and Billing Manual (PDF)
- 2023 Provider and Billing Manual (PDF)
- Inpatient Authorization Form (PDF) - effective 4/15/2024
- Outpatient Authorization Form (PDF) - effective 4/15/2024
- Well-Being Survey (PDF)
- Member Notification of Pregnancy (PDF)
- Notification of Pregnancy Form (PDF)
- Known Issues and Resolution Timeframes
- No Surprises Act Open Negotiation Form (PDF)
- Claim Dispute Form (PDF)
- Providing Quality Care
- Non-Formulary And Step Therapy Exception Request Form (PDF)
National Imaging Associates (NIA) Documents
- National Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQ’s) Prior Authorization Program Physical Medicine Services (PDF)
- Physical Medicine Program Provider Training (PDF)
- Physical Medicine Prior Authorization Quick Reference Guide for Providers (PDF)
- Physical Medicine Request Tip Sheet/Checklist (PDF)
- RadMD Access for Physical Medicine Providers to Request Prior Authorization (PDF)
- RadMD Quick Start Guide Physical Medicine Authorization Requests (PDF)
ABA Tip Sheets
- Caregiver Training (PDF)
- Coordination of Care (PDF)
- Functional Behavior Assessments and Behavior Intervention Plans (PDF)
- Medication Management (PDF)
- Prescription Fulfillment (PDF)
- Transition Planning (PDF)
Behavioral Health
- Co-Occurring Disorders Screening, Diagnosis, and Treatment
- Supporting Patients with Alcohol Use Disorder: Current Approaches to Management and Treatment
- Recovery Support Tools and Resources
- Peer Support Services in Crisis Care (PDF)
- Coordination of Care Checklist (PDF)
- Improving Patient Engagement in Behavioral Healthcare (PDF)
- Primary Care Provider/Behavioral Health Provider Communication Form (PDF)
- Telehealth for Behavioral Health Care (PDF)
- Outpatient OTR Tip Sheet 2023 (PDF)