How To Submit Claims To Ambetter (Centene)

Ambetter (Centene)'s reviewed provider guidance starts with this submission channel: Secure Provider Portal. Confirm the member plan and claim type before using a payer ID or paper address.

At a glance

• Claims submission methods and payer IDs vary by state plan, but Ambetter commonly supports the Secure Provider Portal, EDI/clearinghouse submission, and paper claims by mail. At least one Ambetter state guide lists EDI payer ID 68069, and state manuals/quick-reference guides often specify a paper claims P.O. box or portal URL.

Submission channels

• Secure Provider Portal
• EDI / clearinghouse
• Paper mail

Electronic claims payer IDs

• 68069

Paper claims addresses

• P.O. Box 5010, Farmington, MO 63640-5010

Corrected claims and follow-up

• Corrected-claim handling varies by state; one Ambetter newsletter instructs providers submitting a corrected claim to include frequency code 7 for replacement/corrected or 8 for voided/cancelled, and the original claim number in the appropriate field.

• Use the applicable state provider manual for state-specific corrected-claim instructions.

• Claims status resource 1

Caveats

• Claims submission addresses, payer IDs, and portal names vary by state plan.
• The retrieved materials did not establish one universal claims address for all Ambetter plans.
• A portal URL for claims status is state-specific and was not consistently exposed in the retrieved materials.

Provider resources

• Provider Toolkit: Quick Reference Guide (official)
• Provider Toolkit: Secure Provider Portal (official)
• Provider Toolkit: Prior Authorization Guide (official)
• Prior Authorization Requirements for Health Insurance Marketplace (official)

Sources