1-844-518-9505 - or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider's

 
Plan Brochures & Summaries of Benefits & Coverage. We want to help you find the Ambetter health plan that best fits your budget and your health needs. Use the filters below to narrow your search results and compare our plans. View our 2022 Ambetter Plan Brochure (PDF) to see the valuable benefits each plan has to offer. Plans may vary by …. Html5 nsfw games

Pharmacy. We are committed to providing appropriate, high-quality, and cost-effective drug therapy to all Ambetter Health members. Use our Preferred Drug List to find more information on the drugs that Ambetter Health covers. 2024 Formulary/Prescription Drug List (PDF) 2023 Formulary/Prescription Drug List (PDF) 90-Day Extended Supply ...Sunflower KanCare Medicaid: 1-877-644-4623 (TTY 711) Ambetter from Sunflower Health Plan (Marketplace): 1-844-518-9505 (TTY 711) Wellcare By Allwell (Medicare Advantage):The Ambetter Member Perks Program is available exclusively to Ambetter Members. The program is brought to you by Abenity. As an Ambetter Health member, you can now enjoy healthy discounts to help you be well, stay well, and save smart:Sep 10, 2018 · Attn: Appeals & Grievances. 8325 Lenexa Drive, Suite 410. Lenexa KS 66214. Provider claim disputes should be sent to: Ambetter. Attn: Claim Disputes. PO Box 5000. Farmington, MO 63640-5000. If you have any questions about this, or any aspect of doing business with Ambetter from Sunflower Health Plan, please contact Provider Services at 1-844 ... Ambetter from Sunflower Health Plan: 1-844-518-9505 (TTY 1-844-546-9713) | Ambetter.SunflowerHealthPlan.com | ii Thank you for choosing us as your health insurance plan. We're excited to help you take charge of your health and to help you lead a healthier, more fulfilling life.PHONE 1-844-518-9505 TTY 711 WEB ambetter.sunflowerhealthplan.com PORTAL provider.sunflowerhealthplan.com Confidential and Proprietary Information . THE PROVIDER MANUAL The provider manual is your comprehensive guide to doing business with Ambetter from Sunflower Health Plan.Our contact information is below: Ambetter from Sunflower Health Plan. Grievances and Appeals Department 8325 Lenexa Dr., Suite 410 Lenexa, KS 66214 Fax: 1-844-680-5805 To file a verbal appeal, you can call us at 1-844-518-9505 (TTY 1-844-546-9713). Resolution timeframes may vary based on the type of appeal filed. manner, contact us at 1-844-518-9505 (TTY/TDD 1-844-546-9713) and we can help. In-office wait time - You should not have to wait more than 30 minutes on the day of your scheduled appointment. If the wait time is expected to exceed 30 minutes, the office should offer you the choice between waiting and rescheduling the appointment. You may be the target of a "one-ring" phone scam. One-ring calls may appear to be from phone numbers somewhere in the United States, including three initial digits that resemble U.S. area codes. But savvy scammers often use international numbers from regions that also begin with three-digit codes – for example, "232" goes to Sierra Leone and ...Talk to a registered nurse any time of the day or night with this free service. The 24/7 Nurse Advice Line provides quick, reliable advice for medical situations that aren’t life-threatening. Call the Nurse Advice Line any time at 1-844-518-9505 . Call the 24/7 Nurse Advice Line if you need: Help caring for a sick child1-844-518-9505 (TTY 711). Spanish: Si usted, o alguien a quien está ayudando, tiene preguntas acerca de Ambetter de Sunflower Health Plan y no domina el inglés, tiene derecho a obtener ayuda e información en su idioma sin costo alguno y de manera oportuna. Si usted, o alguien a quienMember Services 1-844-518-9505 Fax 1-888-453-4755 TTY/TDD 1-844-546-9713 Make a Payment 1-844-518-9505 Behavioral Health Services 1-844-518-9505 24/7 Nurse Advice Line 1-844-518-9505 Complaints and Grievances 1-844-518-9505 Emergency 911 Website Ambetter.SunflowerHealthPlan.com When you call, have these items ready: • Your ID …PHONE 1.844.518.9505 | FAX 1.844.824.7705 AMBETTER FROM SUNFLOWER HEALTH PLAN PAGE 1 APPLIED BEHAVIORAL ANALYSIS PRIOR AUTHORIZATION REQUEST FORM Please print clearly and fill out entire form . even if the information is documented in attachments. Incomplete or illegible forms will be returned. MEMBER INFORMATION. DIAGNOSTIC AND TREATMENT ...or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sNow that you’re ready to use your Ambetter Health benefits, take a few first steps to get started. Use your member account to download your ID card and more. Start using your benefits and preventive care services and schedule your first exam to stay healthy.If you need additional help, please contact the Ambetter Health team at 1-844-518-9505 . Managing Health Insurance Costs. There is more than one way to lower the cost of your health insurance plan, like premium payment assistance or cost-sharing reductions. In some cases, you might be eligible for both.Ambetter Inpatient Claim Submission Requirement. Date: 05/07/20. Effective July 1, Ambetter from Sunflower Health Plan will require submission of itemized bills for all inpatient hospital claims expected to reimburse at $25,000 or greater ("qualifying inpatient hospital claims"). The itemized bill will need to meet the following requirements:manner, contact us at 1-844-518-9505 (TTY/TDD 1-844-546-9713) and we can help. In-office wait time - You should not have to wait more than 30 minutes on the day of your scheduled appointment. If the wait time is expected to exceed 30 minutes, the office should offer you the choice between waiting and rescheduling the appointment.agencies is: Ambetter from Sunflower Health Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka, KS 66604, Phone No. 1-785-296-3071.; Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272); Kansas Health Options at 1-Get Started Now! Visit provider.SunflowerHealthPlan.com and click Create an Account. Have your tax ID number ready during sign up. Questions? Contact Ambetter from Sunflower Health Plan at 1-844-518-9505.The No Surprises Act, as part of the Consolidated Appropriations Act (CAA), has been effective with dates of service on and after January 1, 2022, and provides greater consumer protections to patients by addressing surprise medical bills at the federal level. The No Surprises Act required health plans to implement changes that impact both ...1-844-474-7115 PHONE Behavioral Health 1-844-518-9505 1-844-824-7705 After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notifcation of authorization will be returned by phone, fax or web. See reverse side for a list of services that require prior authorization. Please note: 1.Coverage Area Map. Get complete healthcare coverage in Kansas with Ambetter from Sunflower Health Plan. Check out the map below to see where we offer our Marketplace plans. Find coverage in your area. Call us today at 1-844-518-9505 ( TTY 711 ).Page 6 of 7 Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends.The contact information for those agencies is: Ambetter from Sunflower Health Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka,Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 420 SW 9th Street Topeka, KS 66612, Phone No. 1-785-296-3071. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit …doc or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider's chargeOur Health Plans show Our Health Plans menu About Our Plans; Our Benefits; Coverage Area Map; Ways to Save; What is Ambetter? Shop and Compare Plans; Find a DoctorThe Ambetter Member Perks Program is available exclusively to Ambetter Members. The program is brought to you by Abenity. As an Ambetter Health member, you can now enjoy healthy discounts to help you be well, stay well, and save smart:Calling Provider Services at 1-844-518-9505. Mailing a Reconsideration and Claim Dispute Form to the address listed on the form. Claim Appeal (Level II Dispute) – An appeal must be submitted within 180 calendar days from the most recent EOP. Submit an appeal by: Mailing a Reconsideration and Claim Dispute Form to the address listed on the form.Page 6 of 7 Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends.The contact information for those agencies is: Ambetter from Sunflower Health Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka,Providers can obtain prior authorization via the NIA website or 1-844-518-9505. Please ensure that the member has not exhausted his/her benefit prior to providing services, even if an “Approved Authorization” has been obtained.1-844-518-9505 (TTY/TDD 1-844-546-9713) 8325 Lenexa Dr. Suite 410 Lenexa, KS 66214 Ambetter.SunflowerHealthPlan.com. Title: Ambetter 90-Day-Maintenance Drug List- 2020 -Kansas Author: Ambetter from Sunflower Health Plan Subject: Ambetter 90-Day-Maintenance Drug List Keywords:Enter keyword for site search. Search. Contrast On Off. a a aYou should get a flu shot before the flu starts spreading where you live. Fall is the best time to get your yearly shot. If possible, get the shot by the end of October. You can get your flu shot in many doctor's offices. You can also get it in pharmacies, clinics and health centers. Vaccines may also be offered at schools or your workplace.or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sOur contact information is below: Ambetter from Sunflower Health Plan. Grievances and Appeals Department 8325 Lenexa Dr., Suite 410 Lenexa, KS 66214 Fax: 1-844-680-5805 To file a verbal appeal, you can call us at 1-844-518-9505 (TTY 1-844-546-9713). Resolution timeframes may vary based on the type of appeal filed.or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sor call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’sAmbetter.SunflowerHealthPlan.com or call Member Services at 1-844-518-9505 (TTY 711). 5. Retain a copy of all receipts and documentation for your records. Subscriber Information Last Name: First Name: Middle Initial: Patient information Patient’s Ambetter Member . ID#: Last Name: First Name: Middle Initial: Date of Birth (MM/DD/YYYY):About Ambetter Health. Experienced Healthcare. Your Local Community. Ambetter Health offers affordable Health Insurance Marketplace plans. At Ambetter Health, we provide you with the benefits, tools, and coverage you need to take charge of your health. Ambetter Health insurance benefits include: Virtual 24/7 Care. Healthcare Management Programs.or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sPlan Brochures & Summaries of Benefits & Coverage. We want to help you find the Ambetter health plan that best fits your budget and your health needs. Use the filters below to narrow your search results and compare our plans. View our 2022 Ambetter Plan Brochure (PDF) to see the valuable benefits each plan has to offer. Plans may vary by county.Ambetter Member Plan Benefits Resume for Applicable COVID-19 Testing, Screening, and Vaccination Services as of August 1, 2023. Since the federal Public Health Emergency (PHE) related to the COVID-19 pandemic ended on May 11, 2023, Ambetter is committed to providing a smooth transition for both our members and providers as we resume business as ...Use Your Covered Services. Ambetter health insurance plans offer free, covered services so you can save money while staying well. Use your preventive care services like your annual physical and immunizations.1-844-518-9505 (tty/tdd 1-844-546-9713) log on to: ambetter.sunflowerhealthplan.com 2 this contract reflects the known requirements for compliance under the affordable care act as passed on march 23, 2010. as additional guidance is forthcoming from the us department of health and human services, andDo you know where to go when you are sick or injured? A hospital's emergency room is reserved for acute and life-threatening conditions that may only be addressed in a hospital.or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider8445190200. 8445190482. Read more than 3 user reviews and security ratings for number 8445189505 / +1 844-518-9505, mostly rated as positive Company. Get our Free protection against unwanted calls.Page 6 of 7 Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends.The contact information for those agencies is: Ambetter from Sunflower Health Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka,1-844-518-9505 . TTY line . 1-844-546-9713 . Emergency . 911 . 24/7 Nurse Advice Line . 1-844-518-9505 . Interpreter Services . Ambetter from Sunflower Health Plan has a free service to help . members . who speak languages other than English. These services ensure that you and your . physician . can talk about your medical or . behavioral health Every Ambetter insurance plan offers all of your Essential Health Benefits: Emergency services, outpatient or ambulatory services, preventive and wellness services, maternity and newborn care, pediatric services, mental health and substance abuse services, laboratory services, prescription drugs, therapy services (such as physical therapy) and ... 1-844-518-9505 (TTY 711). Spanish: Si usted, o alguien a quien está ayudando, tiene preguntas acerca de Ambetter de Sunflower Health Plan y no domina el inglés, tiene derecho a obtener ayuda e información en su idioma sin costo alguno y de manera oportuna. Si usted, o alguien a quienProviders can obtain prior authorization via the NIA website or 1-844-518-9505. Please ensure that the member has not exhausted his/her benefit prior to providing services, even if an “Approved Authorization” has been obtained.Page 6 of 7 Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends.The contact information for those agencies is: Ambetter from Sunflower Health Plan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka,If you, or someone you are helping, have an auditory and/or visual condition that impedes communication, you have the right to receive auxiliary aids and services at no cost and in a timely manner. To receive translation or auxiliary services, please contact Member Services at 1-844-518-9505 (TTY 711).ndadoc or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider's chargeSunflower Health Plan - Intensive Outpatient/Day Treatment Form Mental Health/Chemical Dependency. SUBMIT TO: Utilization Management Dept. Phone 1-844-518-9505 Fax: 1-844-824-7705. Standard Request - Determination within 14 calender days of receiving all necessary information. Urgent Request - Determiniation within 72 hours. When you choose Ambetter Health, you're covered on these essential medical care and wellness services: Emergency Care. Outpatient or Ambulatory Care. Preventive & Wellness Care. Maternity & Newborn Care. Pediatric Care. Mental Health & Substance Abuse Care. Laboratory Services. Prescription Drugs. Please contact us at the numbers below with any questions you may have. Sunflower KanCare Medicaid: 1-877-644-4623 (TTY 711) Ambetter from Sunflower Health Plan. External Link. (Marketplace): 1-844-518-9505 (TTY 711) Wellcare By Allwell (Medicare Advantage): HMO 1-855-565-9519.The Women's Health and Cancer Rights Act of 1998 is a federal law that helps protect people who choose to have breast reconstruction post mastectomy. Learn more at Ambetter from Sunflower Health Plan.This is the preferred and fastest method. PHONE. 1-844-518-9505. After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notification of authorization will be returned by phone, fax or web. FAX. Medical. 1-844-474-7115. Behavioral Health.If you think this may apply to you, please call us at 1-844-518-9505 . Shop Now! ...1-844-518-9505 (TTY/TDD 1-844-546-9713) Ambetter.SunflowerHealthPlan.com City Pharmacy Name Address Zip Phone Cimarron Coast Health Services 202 N Main St 67835 620-855-2055 Clay Center Ferguson Rexall Drugs 713 5th St 67432 785-632-3121 Clay Center Patterson Family Apothecary 708 Liberty St 67432 785-632-3032Search Results for: The maximum number of characters in a search is 60.General or Routine Questions: Call Provider Services at 1-844-518-9505 (TTY 1-844-546-9713) Complex Questions or Concerns: Please use this Contact Us Form. …Member Services 1-844-518-9505 Fax 1-888-453-4755 TTY/TDD 1-844-546-9713 Make a Payment 1-844-518-9505 Behavioral Health Services 1-844-518-9505 24/7 Nurse Advice Line 1-844-518-9505 Complaints and Grievances 1-844-518-9505 Emergency 911 Website Ambetter.SunflowerHealthPlan.com When you call, have these items ready: • Your IDor call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sphone 1.844.518.9505 fax 1.844.811.5380 SUBSTANCE USE DISORDER TREATMENT DETAILSOur Health Plans show Our Health Plans menu About Our Plans; Our Benefits; Coverage Area Map; Ways to Save; What is Ambetter Health? Shop and Compare PlansContact Member Services at 1-844-518-9505 (TDD/TTY: 1-844-546-9713) Field Name Description Subscriber Information Subscriber is the person: Who enrolls in an Ambetter from Sunflower Health Plan and signs the membership application form on behalf of him/ herself and any dependents. In whose name the premium is paid.1-844-518-9505 (TTY/TDD 1-844-546-9713) 8325 Lenexa Dr. Suite 410 Lenexa, KS 66214 Ambetter.SunflowerHealthPlan.com. Auranofin Azathioprine Azilsartan Medoxomil Bor call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sPara hablar con un intérprete, llame al 1-844-518-9505 (TTY/TDD 1-844-546-9713). Nếu quý vị, hay người mà quý vị đang giúp đỡ, có câu hỏi về Ambetter from Sunflower Health Plan, quý vị sẽ có quyền được giúp và có thêm thông tin bằng ngôn ngữ của mình miễn phí.If you, or someone you are helping, have an auditory and/or visual condition that impedes communication, you have the right to receive auxiliary aids and services at no cost and in a timely manner. To receive translation or auxiliary services, please contact Member Services at 1-844-518-9505 (TTY 711).c or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sdoc or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider's chargeor call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sThere may be a longer wait time to see specialists. If you can’t get an appointment in time, contact us to get help at 1-844-518-9505 (TTY 711). In-ofice wait time should be within 30 minutes on the day of your appointment. If the wait is expected to take more than 30 minutes, the ofice should ofer you to reschedule.No paper wasted, no mail piled up in your home, and no misplaced bills! Sign up now! Everything You Need. Right Here. With Ambetter from Sunflower Health Plan it's easy to take charge of your health. As an Ambetter member, you have access to the helpful tools and resources you need to manage your plan - all in one place, 24/7.doc or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider's chargeIf you wish to file a grievance, appeal, concern or recommendation, please complete this form. If you choose not to complete this form, you may write a letter that includes the information requested below. The completed form or your letter should be mailed to: Phone: 1-844-518-9505 (TTY 711) Fax: 1-833-886-7956 Ambetter from Sunflower Health ...If you need additional help, please contact the Ambetter Health team at 1-844-518-9505 . Managing Health Insurance Costs. There is more than one way to lower the cost of your health insurance plan, like premium payment assistance or cost-sharing reductions. In some cases, you might be eligible for both.1-844-518-9505 or TTY 1-844-546-9713 Find us on the web Ambetter.SunflowerHealthPlan.com There are many services that can be accessed through our website and our secure provider portal including eligibility verification, benefits, cost shares, prior authorization submissions, claim submissions, claim statussex characteristics), please contact Member Services at 1844- -518-9505 (TTY 711). You may also submit a grievance by phone to 1-844-518-9505 (TTY 711). For information on filing a discrimination complaint directly with the U.S. Department of Health and Human Services, Office of Civil Rights, please visit1-844-474-7115 PHONE Behavioral Health 1-844-518-9505 1-844-824-7705 After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notifcation of authorization will be returned by phone, fax or web. See reverse side for a list of services that require prior authorization. Please note: 1.1-844-518-9505 (tty 1-844-546-9713) log on to: ambetter.sunflowerhealthplan.com . this . contract . reflects the known requirements for compliance under the affordable care act as passed on march 23, 2010. as additional guidance is forthcoming from the us department of health and human services, and

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844-518-9505 (TTY 1-844-546-9713). A licensed nurse is always available and ready to answer your health questions. In an emergency, call 911 or head straight to the nearest emergency room. 34368KS012-2023-OC . Member Services Department: 1-844-518-9505 TDD/TTY 1-844-546-9713 . Log on to: Ambetter.SunflowerHealthPlan.comor call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan’s network. 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You will pay the most if you use an out-of-network provider, and you might receive a or call 1-844-518-9505 (TTY/TDD 1-844-546-9713) for a list of network providers. This plan uses a provider network. You will pay less if you use a provider in the plan's network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider'sPlan at 1-844-518-9505 (TTY/TDD 1-844-546-9713); Kansas Insurance Department, 1300 SW Arrowhead Rd Topeka, KS 66604, Phone No. 1-785-296-3071. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www ...This is the preferred and fastest method. PHONE. 1-844-518-9505. After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notification of authorization will be returned by phone, fax or web. FAX. Medical. 1-844-474-7115. Behavioral Health.Sunflower Health Plan - Intensive Outpatient/Day Treatment Form Mental Health/Chemical Dependency. SUBMIT TO: Utilization Management Dept. Phone 1-844-518-9505 Fax: 1-844-824-7705. Standard Request - Determination within 14 calender days of receiving all necessary information. Urgent Request - Determiniation within 72 hours.A mammogram is an X‐ray image of your breasts. Mammograms can help physicians detect early signs of malignant growths, commonly cancer. Getting regular mammograms can help you live a longer and healthier life. If you're preparing to have a mammogram, it helps to keep the following in mind. Mammograms are recommended based on age and risk as ...1-844-518-9505 (TTY/TDD 1-844-546-9713) MO. Ambetter from Home State Health. 1-855-650-3789 (TTY/TDD 1-877-250-6113) MS. Ambetter from Magnolia Health. 1-877-687 …Page 1 of 7 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2024 - 12/31/2024 Ambetter from Sunflower Health Plan Coverage for: Individual/Family | Plan Type: EPO Elite Bronze + Vision + Adult Dental: Standard Bronze On Exchange Plancalling the NIA Call Center at 1-844-518-9505. A peer-to-peer discussion may not be necessary if the requested clinical documentation is sent prior to contacting NIA. A peer-to-peer may be initiated by the office staff (non-clinical), but the case discussion must be conducted by a licensed clinician from the provider's office..

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