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Ambetter from PA Health & Wellness (Commercial/Exchange)
Risk Adjustment
Pharmacy
Provider Relations
Provider Resources
Manuals, Forms and Resources
Reporting Communicable Diseases
Submit Attestations Online for Chronically Ill Members
Eligibility Verification
Nursing Facility
Participant Complaint, Grievance, and DHS Fair Hearing Process
Integrated Care
Prior Authorization
National Imaging Associates (NIA)
Provider Newsletter
Report Fraud, Waste and Abuse
Patient Centered Medical Home Model
Choosing Wisely
Electronic Transactions
PaySpan - EFT/ERA
Appeal and Reconsideration Procedures
Clinical & Payment Policies
Quality Program
HEDIS
Medical Records
Practice Guidelines
Providing Quality Care
Service Coordination Entities
Provider Town Hall
Provider Training
Medicare Model of Care (MOC) Training Attestation
HCBS Training Attestation
Provider Updates
Provider Relations
Stay tuned to this page for exciting Provider Relations team information and updates!
