Manuals, Forms and Resources
Are you looking for Ambetter? Please visit the Ambetter website at https://ambetter.pahealthwellness.com.
We will continue to add resources to this section over the next several months.
- Allwell Provider Manual 2019 (PDF)
- Community HealthChoices Provider Manual (PDF)
- PA Health & Wellness CHC Billing Manual (PDF)
- Provider FAQs (PDF)
- Medicaid Inpatient Authorization Form (PDF)
- Medicaid Outpatient Authorization Form (PDF)
- Medicare Inpatient Authorization Form (PDF)
- Medicare Outpatient Authorization Form (PDF)
- Medication Prior Authorization Form (PDF)
- Obstetrical Needs Assessment Form (PDF)
- General Specialty Medication Prior Authorization Form (PDF)
- Consent For Provider to File a Complaint or Grievance for Participant Form (PDF)
- Qualified Medicare Beneficiaries-Billing FAQ (PDF)
- Non-PAR Provider PA (PDF)
- PAR Provider PA (PDF)