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Handbooks & Forms for Members | Ambetter of Tennessee
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- Transparency Notice 2020
- Transparency Notice 2019
- Statement of Non-Discrimination
- Find a Provider Guide (PDF)
- Preventive Guide (PDF)
- Dr. Office Visit Checklist (PDF)
- Women's Health and Cancer Rights Act Annual Notice
- Authorization to Disclose Health Information Form (PDF)
- Revocation of Authorization Form (PDF)
- Grievance & Appeals Form (PDF)
- Member Reimbursement Medical Claim Form (PDF)
- Prescription Claim Reimbursement Form (PDF)
- Donor Transplant Travel Reimbursement Form (PDF)
- Recipient Transplant Travel Reimbursement Form (PDF)
- Member Transplant Travel Reimbursement Policy (PDF)