Superior Health Provider Forms

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Provider Forms Superior HealthPlan

(5 days ago) WEBBehavioral Health Disclosure of Ownership and Control Interest Statement (PDF) Behavioral Health Facility and Ancillary Credentialing Application (PDF) Behavioral …

https://www.superiorhealthplan.com/providers/resources/forms.html

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Provider Resources, Manuals, and Forms - Ambetter from Superior …

(1 days ago) WEBAmbetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms.html

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Prior Authorization Superior HealthPlan

(3 days ago) WEB02/02/24. Effective March 1, 2024, Superior HealthPlan will no longer require prior authorization for certain genetic testing for Medicaid (STAR, STAR Health, STAR Kids, …

https://www.superiorhealthplan.com/providers/preauth-check.html

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Texas Provider Resources Superior HealthPlan

(9 days ago) WEBSuperior HealthPlan equips each of our providers with the most up-to-date resources available for Texas Medicaid (STAR, STAR+PLUS, STAR Kids, STAR Health), CHIP, …

https://www.superiorhealthplan.com/providers/resources.html

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REQUEST FOR PRIOR AUTHORIZATION - Superior HealthPlan

(9 days ago) WEBServicing Provider Information Contact Information. NPI* TPI* Tax ID* Last Name, First Initial or Facility Name STAR Kids/STAR Health LTSS.. 1-877-644-4561. …

https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_2013218-PriorAuthForm-P.pdf

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Reconsideration Request Form - Superior HealthPlan

(7 days ago) WEBProvider NPI Date of last Explanation of Payment Mail completed forms and all attachments to: Superior HealthPlan . Claims Reconsiderations . PO BOX 3003 . …

https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_20195192B-Claim-Reconsideration-Form-P-508-05082019.pdf

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PROVIDER REQUEST FOR RECONSIDERATION AND CLAIM …

(2 days ago) WEBUse this form as part of the Ambetter from Superior Healthplan Request for Reconsideration and Claim Dispute process. Request for Reconsideration (Level I) is a …

https://ambetter.superiorhealthplan.com/content/dam/centene/Superior/Ambetter/PDFs/TX_AMB_Claim_Dispute_Form.pdf

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Grievance and Appeals Forms Ambetter from Superior HealthPlan

(9 days ago) WEBTo file the member complaint, send to: Ambetter from Superior HealthPlan. Complaints Department. 5900 E. Ben White Blvd. Austin, TX 78741. Fax: 1-866-683-5369. The …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms/grievance-appeals.html

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Member Primary Care Provider ( PCP) Change Request Form

(9 days ago) WEBPlease print clearly and complete all fields. Be sure to sign the bottom of the form. You can also choose a new PCP by calling Superior STAR+PLUS MMP Member Services at 1 …

https://mmp.superiorhealthplan.com/content/dam/centene/Superior/mmp/pdfs/H6870_MMP_109290E_Final-approved.pdf

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Pre-Auth Tool Ambetter from Superior HealthPlan

(Just Now) WEBCardiac, Sleep Study Management and Ear, Nose and Throat (ENT) procedures need to be verified by TurningPoint. Please contact TurningPoint by phone (1-855-336-4391) or fax …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms/pre-auth.html

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Prior Authorization (Part C) - Superior HealthPlan

(6 days ago) WEBIf you are asking for a standard appeal or a fast appeal, make your appeal in writing or call us. You can submit a request to the following address: OR. FAX to: 1-844 …

https://mmp.superiorhealthplan.com/benefits/prior-auth-part-c.html

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PROVIDER CLAIM DISPUTE FORM - Ambetter from Superior …

(6 days ago) WEBMail completed form(s) and attachments to: Ambetter from Superior HealthPlan. Attn: Claim Dispute. PO Box 5000. Farmington, MO 63640-5000. Attach a …

https://ambetter.superiorhealthplan.com/content/dam/centene/Superior/Ambetter/PDFs/TX-PROVIDER-CLAIM-DISPUTE-FORM_20141210.pdf

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Texas Medicaid & Health Insurance Superior HealthPlan

(5 days ago) WEBYou are now able to view your health information from a third party app on a mobile device or computer! Check out the Interoperability Page to learn more. Superior HealthPlan exists to improve the health of Texas Medicaid beneficiaries through focused, compassionate & coordinated care. Get Texas health insurance or become a provider today.

https://www.superiorhealthplan.com/

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Resources / Materials - Superior HealthPlan

(9 days ago) WEBMedically Necessary - Health care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease or its symptoms and that meet accepted …

https://mmp.superiorhealthplan.com/resources.html

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English - Superior HealthPlan

(5 days ago) WEBLast updated: 10/01/2023. Material ID: H6870_WEBSITE_2024_APPROVED_10/11/2023. Superior HealthPlan STAR+PLUS …

https://mmp.superiorhealthplan.com/

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Ambetter from Superior Healthplan - Inpatient Authorization …

(2 days ago) WEBBehavioral Health Requests/Medical Records: Fax 844-824-9016 Inpatient Authorization Form Author: Ambetter from Superior Healthplan Keywords: inpatient authorization …

https://ambetter.superiorhealthplan.com/content/dam/centene/Superior/Ambetter/PDFs/ET-Ambetter-Inpatient-1423_06252020.pdf

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Forms - Ambetter from Superior HealthPlan

(Just Now) WEBAmbetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, …

https://ambetter.superiorhealthplan.com/forms.html

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Clover Quick Reference Guide

(4 days ago) WEBClover Health P.O. Box 3236 Scranton, PA 18505 To find an in-network provider Provider Directory To view pre-authorization criteria Formulary To dispute a payment Payment …

https://www.cloverhealth.com/filer/file/1453950875/82/

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Superior Vision - Find an Eye Care Professional

(5 days ago) WEBVersant Health, Inc. (through its wholly owned subsidiaries Superior Vision, Inc., Davis Vision, Inc., and Superior Vision Benefit Management, inc.) is a licensed third-party …

https://superiorvision.com/locator/

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Provider Login Superior HealthPlan

(5 days ago) WEBProviders contracted for Wellcare Complete can login/register here. Secure Web Portal Support. For support while using the web portal, please call 1-866-895-8443 or email …

https://www.superiorhealthplan.com/providers/login.html

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