Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Ambetter Health before sending sensitive documents. FaxFlow is not affiliated with this organization.
Ambetter Health fax number
(855) 227-3804
Prior Authorization and Release of Information (ROI)
Used for: Submitting prior authorizations for medical/behavioral services and handling ROI requests
Fax destination details
- Department
- Prior Authorization and Release of Information (ROI)
- Purpose
- Submitting prior authorizations for medical/behavioral services and handling ROI requests
- Form
- Release of Information Form — Release of Information Form (ROI)
- Address
- 750 Prides Crossing, Suite 200, Newark, DE 19713
- Voice phone
- 1-833-919-3214
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill in patient/member details and submit the ROI form; fax to 1-855-227-3804 as part of information-sharing requests.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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