Manuals, Forms and Resources
Attention
Before submitting a credentialing application, please complete the contracting process first. To learn more about contracting with Arkansas Health & Wellness fill out this Contracting Form.
Arkansas Health & Wellness Credentialing Applications
Arkansas Health & Wellness Manuals & Forms
- Account Manager Secure Portal (PDF)
- PAI Provider Self Reporting Form (PDF)
- Provider Data Change Form (PDF)
Reference Materials
- 2024 Provider and Billing Manual (PDF)
- 2023 Provider and Billing Manual (PDF)
- Quick Reference Guide (PDF)
- ICD-10 Information
- Payspan (PDF)
- Secure Portal (PDF)
- Provider Portal Initiative FAQ (PDF)
- Envolve Vision Plan Specifics (PDF)
- Ambetter Reimburses for Substance Use Services (PDF)
- Long-Acting Medications as First-Line Treatment in Schizophrenia (PDF)
- Provider Data Change Form (PDF)
- Non-Formulary And Step Therapy Exception Request Form (PDF)
- Opioid Resources for Prescribers
- Ambetter Envolve Eye Exam Incentive Flyer (PDF)
- Wellcare by Allwell Envolve Eye Exam Incentive Flyer (PDF)
- Intro to Sober SidekickProvider Training (PDF)
- Sober Sidekick Transforming Recovery and Enhancing Care (PDF)
- Risk Adjustment Coding & Documentation (PDF)
- PCP Change Request Form (PDF)
- Medicare Advantage Provider Manual (PDF)
Medical Management/Behavioral Health
- Pre-Auth Needed?Prior Authorization Guide (PDF)
- Inpatient Prior Authorization Fax Form (PDF)
- Outpatient Prior Authorization Fax Form (PDF)
- Grievance and Appeals Discharge Consultation Form (PDF)
- Turning Point Prior Authorization
Claims and Claim Payment
Quality
- Practice Guidelines (PDF)
- Cultural Competency Plan (PDF)
- Quality Improvement (QI)
- Ambetter Member Reassignment Form (PDF)
- Providing Quality Care
Provider Contracting
Attention: If you would like to become a provider within our network, please fill out the Become a Provider form or email ArkansasContracting@centene.com.
Provider Credentialing
If you are already contracted, you can complete the forms below and return to arkcredentialing@centene.com for enrollment.
- Allied and Advanced Practice Nurse Credentialing Application (PDF)
- Medical Doctor or Doctor of Osteopathy Credentialing Application (PDF)
- Arkansas Roster Template - June 2026 (CSV)
To see all coding tip sheets, please visit Coding Tip Sheets and Forms.
Ambetter Manuals & Forms
For Ambetter information, please visit our Ambetter website.
Wellcare by Allwell Manuals & Forms
For Wellcare by Allwell information, please visit our Wellcare by Allwell website.