1. The Ambetter secure provider portal found at: Ambetter.SuperiorHealthPlan.com • If you are already a registered user of the Superior HealthPlan secure portal, you do NOT need a separate registration. 2. Call Provider Service at: 1-877-687-1196 • Provider services is available to assist you M -F 8:00 AM - 6:00 PM CST.Contact us at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. **Formerly known as Ambetter Telehealth. Cost sharing may apply when using Virtual 24/7 Care or Virtual Primary Care.Payspan (PDF) Secure Portal (PDF) Provider Orientation 2024 (PDF) Provider Orientation 2023 (PDF) Health Literacy and Culture (PDF) Telehealth and Virtual Services Guide (PDF) Non-Formulary And Step Therapy Exception Request Form (PDF) Provider Awareness Handout (PDF) Provider Awareness Flyer (PDF)Superior is a wholly owned subsidiary of Centene Corporation, a leading Fortune 500 healthcare enterprise that is committed to helping people live healthier lives. With 80,000 employees nationwide, we encourage you to visit our career portal to explore how you can become part of the Centene family. In March 2020, Superior shifted its entire ...Ambetter from Coordinated Care is underwritten by Coordinated Care Corporation which is a Qualified Health Plan issuer in the Washington Health Benefit Exchange. This is a solicitation for insurance. ©2024 Coordinated Care Corporation, Ambetter.CoordinatedCareHealth.com.Find info and tools you can use to build a healthier life. Find everything you need to manage your affordable health insurance benefits in the Ambetter from Superior HealthPlan member portal. Pay your premium, log in, find a doctor & more.Date: 11/01/22. Texans who sign up by December 15, 2022, for an insurance plan through the Health Insurance Marketplace will get coverage starting on New Year’s Day. Open Enrollment is underway, and Ambetter from Superior HealthPlan will be offered in 149 Texas counties in 2023, including four new ones: Andrews, Colorado, Gray, and Walker ...Starting January 1, 2020, the Ambetter fee schedule name will change from Payor Medicare Fee Schedule to Payor Fee Schedule. This is to differentiate the Ambetter fee schedule from the traditional Medicare fee schedule and avoid confusion. Both schedules provide the same reimbursement, so this change will not have a financial impact.• Ambetter from Superior HealthPlan (Ambetter Health) provides market-leading, affordable health insurance on the Health Insurance ... – This can be done through the Secure Provider Portal. Ambetter Health Silver and Gold Note: Possession of an ID Card does not guarantee eligibility and benefits.Plan Brochures & Summaries of Benefits & Coverage. We want to help you find the Ambetter health plan that best fits your needs and your budget. To begin, choose which type of health coverage you are seeking. EPO Plans - EPO plans, or Exclusive Provider Network plans, cover only in-network care, but can often times offer more provider options.Your Ambetter online member account provides many ways to get care, including finding a Primary Care Provider (PCP), locating an in-network Urgent Care Center, or even …Provider Portal (claims, authorizations, eligibility, etc.). Note: The Secure Provider Portal will randomly launch the Superior Challenge Survey on a quarterly basis to users with an Account Manager role. This survey is used to verify provider demographic data and monitor provider adherence with state requirements. The survey gives1-844-307-4442. Medical (Inpatient) 1-866-838-7615. Behavioral Health (Inpatient) 1-844-824-9016. Please note: Emergency services DO NOT require prior authorization. All out-of-network services and providers DO require prior authorization. Failure to complete the required authorization or notification may result in a denied claim.To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member PortalExternal Link or Provider Portal ...Healthy partnerships are our specialty. With Ambetter Health, you can rely on the services and support that you need to deliver the best quality of patient care. You're dedicated to your patients, so we're dedicated to you. When you partner with us, you benefit from years of valuable healthcare industry experience and knowledge.Mental Health Rehabilitation and Targeted Case Management (SB58) Training (PDF) Nursing Facility Provider Training (PDF) Outpatient Behavioral Health Provider Training (PDF) STAR Health (Foster Care) Resources. External Link. , including but not limited to the STAR Health Training, 3 in 30 and Texas Child and Adolescent Needs and Strengths (CANS).Call Provider Services For Help. If you need help, call Provider Services at 1-877-687-1169 (Relay Florida 1-800-955-8770) Monday through Friday from 8 a.m. to 8 p.m. Eastern. Stay up to date on Ambetter from Sunshine Health provider notices by reviewing and bookmarking Provider News.Search without logging in. Choose one of these options: Your home state. Ambetter member ID number. Last 6 digits of your SSN. Use Ambetter's tool to help you find an in-network doctor, specialist, or health care facility such as a hospital, urgent care clinic, or pharmacy.1. The Ambetter secure provider portal found at: Ambetter.SuperiorHealthPlan.com • If you are already a registered user of the Superior HealthPlan secure portal, you do NOT need a separate registration. 2. Call Provider Service at: 1-877-687-1196 • Provider services is available to assist you M -F 8:00 AM – 6:00 PM CST.1. On the Secure Provider Portal found at Provider.SuperiorHealthPlan.com. ‒If you are already a registered user of the Secure Provider Portal, you do not need a separate registration. 2. 24/7 Interactive Voice Response system at 1-800-964-2777. ‒Enter the Member ID Number and the month of service to check eligibility. 3.Contact us at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. Use your member account to download your ID card, activate your My Health Pays® rewards account and more with ...Ambetter Health can help. You can count on us to share helpful information about COVID, how to prevent it, and recognize its symptoms. Because protecting peoples' health is why we're here, and it's what we'll always do. Ambetter from Sunflower Health Plan offers quality and affordable health insurance in Kansas that fits your needs and ...National Imaging Associates - Prior Authorization Requests Online, Phone or Fax for Physical, Occupational and Speech Therapy Services. Date: 01/05/22 Effective December 1, 2021, Superior HealthPlan delegated utilization review for physical, occupational and speech therapy (PT, OT, ST) services that require prior authorization to National Imaging Associates (NIA) for Superior's STAR, STAR ...Your Ambetter online member account is a powerful tool you can use anytime to manage your insurance plan. There, you can find information about your Ambetter coverage, access options for care and much more — all in one place. Your Ambetter online member account puts you in control of your health plan. Discover all the ways you can manage your ...HOW TO USE THIS PROVIDER MANUAL . Ambetter is committed to assisting its provider community by supporting their efforts to deliver well-coordinated and appropriate health care to our members. Ambetter is also committed to disseminating comprehensive and timely information to its providers through this provider manual regarding Ambetter’sContact Ambetter from Superior HealthPlan at 1-877-687-1196. Get Started Now! Visit Provider.SuperiorHealthPlan.com and click Create an Account. Have your tax ID number ready during sign up. 2016 Celtic Insurance Company.Our resources for Texas providers within the Superior network includes the tools and support you need to deliver the best quality of care. Links to specific provider resources can be found by using the left navigation bar to access provider webpages or clicking the links within the sections below. For Ambetter from Superior HealthPlan provider ...The only thing you need to do is log in to your Ambetter Health account and activate My Health Pays. That’s it! Then, you can start earning rewards every time you complete an activity. Check out which rewards you qualify for based on your state’s plan. Get Rewards. Alabama. Arizona. Arkansas.Access patient information, submit claims, and manage prior authorizations for Ambetter from Superior HealthPlan members. Sign up for a free account and enjoy the features of the secure provider portal.Ambetter Virtual Access Plans. We also offer a state-mandated plan that includes all required benefits. If you are interested in learning more about this plan, please call Member Services at 1-877-687-1196 (Relay Texas/TTY: 1-800-735-2989) 8 a.m. to 8 p.m. CST, Monday through Friday or email [email protected] you need help finding a pharmacy, please call Member Services at 1-877-687-1196. Relay Texas/TTY users should call 1-800-735-2989. More on Ambetter Health’s pharmacy program. Use our Preferred Drug List (Formulary) to find more information on the drugs that Ambetter Health covers. 2024 Formulary/Prescription Drug List (PDF)If you are already contracted with Superior, please visit the Add a Product page and complete the online form to add Ambetter to your contract. Required fields are marked with an asterisk (*) The form fields are loading, please wait. Thank you for your interest in becoming a network provider with Ambetter from Superior HealthPlan. If you would ...You 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.If you are a contracted PA Health & Wellness provider, you can register anytime. If you are a non-contracted provider, you will be able to register after you submit your first claim. Once you have created an account, you can use the PA Health & Wellness provider portal to: Verify participant eligibility. Manage claims.For Providers show For Providers menu. Provider Login; Drug Coverage; Prior Auth Requirements; Provider Resources ... to select their health insurance plan. Ambetter from Superior HealthPlan wants to make sure your patients know what to do to take charge of their health and get coverage for 2024. ... Contact Ambetter Health at 1-877-687-1196 ...Contact us at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. **Formerly known as Ambetter Telehealth. Cost sharing may apply when using Virtual 24/7 Care or Virtual Primary Care.Providers 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 [email protected]. *In addition to updating information with Superior, providers must also update their demographics with Texas Medicaid & Healthcare ...National Imaging Associates - Prior Authorization Requests Online, Phone or Fax for Physical, Occupational and Speech Therapy Services. Date: 01/05/22 Effective December 1, 2021, Superior HealthPlan delegated utilization review for physical, occupational and speech therapy (PT, OT, ST) services that require prior authorization to National Imaging Associates (NIA) for Superior's STAR, STAR ...provider.magnoliahealthplan.com. This is the preferred and fastest method. PHONE. 1-877-687-1187. 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 and Behavioral Health. 1-855-300-2618.HOW TO USE THIS PROVIDER MANUAL . Ambetter is committed to assisting its provider community by supporting their efforts to deliver well-coordinated and appropriate health care to our members. Ambetter is also committed to disseminating comprehensive and timely information to its providers through this provider manual regarding Ambetter’sSupport for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster. Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies. Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing. Training Requirement: Model of Care.Create Your Own Account. Create your own health plan account online today! Superior has many convenient and secure tools to assist you and give you access to better health-care information. To enter our secure portal, click on the login button. A new window will open. You will be able to login or register.Our resources for Texas providers within the Superior network includes the tools and support you need to deliver the best quality of care. Links to specific provider resources can be found by using the left navigation bar to access provider webpages or clicking the links within the sections below. For Ambetter from Superior HealthPlan provider ...Superior HealthPlan. Superior HealthPlan is a leading, multiline managed care organization that has been providing quality health care to Texas residents since 1999. Superior is committed to transforming the health of the community, one person at a time through affordable and reliable health-care plans including Medicaid, Medicare, and coverage ...Procedures And Requirements. Prior authorization assistance for members and providers is available between 6:00 a.m. and 6:00 p.m., Central Time, Monday through Friday on each day that is not a legal holiday and between 9:00 a.m. and noon, Central Time, on Saturday, Sunday, and legal holidays.Welcome to Ambetter from Superior HealthPlan (Ambetter). Thank you for participating in our network of physicians, hospitals, and other healthcare professionals. Centene shares your dedication to improving the health of our community. We focus on building strong, long-term partnerships with providers—so you can depend on us now and in the future.All claims submitted to Superior must include all the required, valid clean claim data elements. The billing provider address is a required data element needed in a claim. Providers can enter the billing provider address in the following location for: Paper claims. CMS 1500 Claim Form - Box 33; UB-04 Claim Form - Box 1; Electronic claims. Loop ...Use the Pre-Auth Needed tool on our website to determine if prior authorization is required. Submit prior authorizations via: Secure Provider Portal. External Link. Medical Fax: 1-855-678-6981. Behavioral Fax: 1-844-208-9113. Phone: 1-877-687-1169. Claims. Timely Filing guidelines: 180 days from date of service.Please complete this form if you have received a bill from a provider for any amount greater than your copayment, coinsurance, or deductible. If you have any questions or if you would like additional assistance, please contact Ambetter Member Services at 1-877-687-1196 (Relay Texas/TTY 1-800-735-2989) from 8 a.m. to 8 p.m. CST. The "Inform ...Support for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster. Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies. Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing. Training Requirement: Model of Care.UnitedHealth Group believes this situation will impact "a substantial proportion of people in America" and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 866-262-5342 ...Toll free: 1-800-731-8527. Hours: Monday - Friday, 8 a.m. - 5 p.m., excluding holidays. Email: [email protected]. To learn more about Texas Children's® Link, you can view helpful 'How-To Videos' accessible on the portal under Quick Links.Use this form as part of the Ambetter from Superior Healthplan Request for Reconsideration and Claim Dispute process. Request for Reconsideration (Level I) is a communication from the provider about a disagreement with the manner in which a claim was processed. Claim Dispute (Level II) should be used only when a provider has received an ...Superior HealthPlan Headquarters. 5900 E Ben White Blvd. Austin, TX 78741. (800) 218-7453. Apply for Texas health insurance coverage at eHealthInsurance. We offer thousands of health plans underwritten by more than 180 of the nation's health insurance companies. Compare Texas health plans side by side, get health insurance quotes, apply online ...As a result the following policies are effective on January 31, 2023, at 12:00AM. Changes in these policies reflect preauthorization requirement amendments that are less burdensome to insureds, physicians, or health care providers. To review all policies, please visit Superior's Clinical, Payment & Pharmacy Policies webpage.Mental Health Rehabilitation and Targeted Case Management (SB58) Training (PDF) Nursing Facility Provider Training (PDF) Outpatient Behavioral Health Provider Training (PDF) STAR Health (Foster Care) Resources. External Link. , including but not limited to the STAR Health Training, 3 in 30 and Texas Child and Adolescent Needs and Strengths (CANS).Our Benefits. Get the most from your Ambetter Health insurance with our health and wellness benefits. Choose optional, affordable vision and dental insurance plans, enroll in our mail-order pharmacy, or find extra support through Ambetter telehealth or care management programs. We’re adding value to your affordable health insurance plan with ...Access patient information, submit claims, and manage prior authorizations for Ambetter from Superior HealthPlan members. Sign up for a free account and enjoy the features of the secure provider portal.Pennsylvania. South Carolina. Tennessee. Texas. Washington. As an Ambetter network provider, you can rely on the support you need to deliver high quality patient care. Learn about our resources for providers.For Members. Superior HealthPlan offers health insurance plans that fit your needs. Program eligibility depends on your age, income, family size and any special health needs you may have. View all of our available health insurance plans below. Select the program you are enrolled with. This will take you to more information about that program.Ambetter from Superior HealthPlan offers a provider resource toolkit so you can focus on providing care. Learn more about our health insurance provider support.Access the secure web portal to file claims, verify eligibility, request authorizations and more for Superior HealthPlan. Providers contracted for Ambetter from Superior HealthPlan can also login/register here.Our free 24/7 nurse advice line makes it easy to get answers to your health questions. You don’t even have to leave home! Staffed by licensed nurses, our nurse advice line runs 24 hours a day, 7 days a week. Call 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989 ) if you have questions about:Contact us at 1-877-687-1196 (Relay Texas/TTY 1-800-735-2989) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. ***Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO ...If you are already contracted with Superior, please visit the Add a Product page and complete the online form to add Ambetter to your contract. Required fields are marked with an asterisk (*) The form fields are loading, please wait. Thank you for your interest in becoming a network provider with Ambetter from Superior HealthPlan. If you would ...1. The Ambetter Secure Portal found at Ambetter.SuperiorHealthPlan.com • If you are already a registered user of the Superior HealthPlan portal, you do not need a separate registration. 2. Fax Requests to: 1-855-537-3447 • The fax authorization forms are located on our website at Ambetter.SuperiorHealthPlan.com. 3.Why is Ambetter from Superior HealthPlan showing up first in my ... The following questions apply to STAR Health, STAR Kids and STAR+PLUS only. ... For assistance with the Secure Provider Portal, contact Superior’s Web Applications Support Desk at 1-866-895-8443 or emailStay with the health plan you trust. If you're a member of Ambetter, you have access to coverage with Allwell - a Medicare Advantage plan offered from Superior HealthPlan. With Allwell, you'll get the same local service and member experience you've come to know, plus more: Continue to rely on great healthcare coverage from the plan you trust!Ambetter Health can help. You can count on us to share helpful information about COVID, how to prevent it, and recognize its symptoms. Because protecting peoples' health is why we're here, and it's what we'll always do. Learn More. Ambetter from Home State Health offers affordable health insurance plans for individuals and families in ...Nurse Advice Line. We make it possible for you to talk to a registered nurse at any time—24 hours a day, 7 days a week, 365 days a year. Our nurse advice line helps you and your family receive the care you need, when you need it. It's staffed with experienced nurses who are ready and eager to help you. You can call our nurse advice line ...1. On the Secure Provider Portal at Provider.SuperiorHealthPlan.com. ‒ If you are already a registered user of the Secure Provider Portal, you do not need a separate registration. 2. Fax requests to 1-855-537-3447. ‒ The fax authorization forms are located on our website at Ambetter.SuperiorHealthPlan.com. 3.HMO Plan Brochures & Summaries of Benefits & Evidence of 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 2023 Ambetter Plan Brochures to see the valuable benefits each plan has to offer.Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, Inc. These companies are each Qualified Health Plan issuers in the Texas Health Insurance Marketplace.Procedures And Requirements. Prior authorization assistance for members and providers is available between 6:00 a.m. and 6:00 p.m., Central Time, Monday through Friday on each day that is not a legal holiday and between 9:00 a.m. and noon, Central Time, on Saturday, Sunday, and legal holidays.So, to make working with us easier, we developed the Ambetter Provider Toolkit. It's designed to provide you with valuable education and materials to simplify your administrative responsibilities—so you can focus on providing care. Provider Quick Reference Guide. Prior Authorization Guide. Electronic Funds Transfer (EFT) Features.Create Your Own Account. Create your own health plan account online today! Superior has many convenient and secure tools to assist you and give you access to better health-care information. To enter our secure portal, click on the login button. A new window will open. You will be able to login or register.EntryKeyID - AuthenticationWith the growing popularity of protein powders in the health and fitness industry, it’s important to understand the differences between various types of protein sources. One such o...Starting January 1, 2020, the Ambetter fee schedule name will change from Payor Medicare Fee Schedule to Payor Fee Schedule. This is to differentiate the Ambetter fee schedule from the traditional Medicare fee schedule and avoid confusion. Both schedules provide the same reimbursement, so this change will not have a financial impact.Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, Inc. These companies are each Qualified Health Plan issuers in the Texas Health Insurance Marketplace. This is a solicitation for insurance. ©2024 Celtic Ins. Expand ...Date: 05/24/24. Superior HealthPlan has updated certain clinical policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result, the following policies are effective on May 22, 2024, at 12:00AM. Changes in these policies reflect preauthorization requirement amendments ...Ambetter from Superior Healthplan Attn: Level I - Request for Reconsideration PO Box 5010 Farmington, MO 63640 -5010 ... Farmington, MO63640-5010. Title: Texas - Provider Request for Reconsideration and Claim Dispute Form Author: Superior Health plan Subject: Provider Request for Reconsideration and Claim Dispute Form Keywords: claim, dispute ...Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, Inc. These companies are each Qualified Health Plan issuers in the Texas Health Insurance Marketplace. This is a solicitation for insurance. ©2024 Celtic Ins. Expand ...Texas residents interested in learning more about Ambetter from Superior HealthPlan or enrolling in a health plan during the open enrollment period may visit www.ambetter.superiorhealthplan.com. *Restrictions apply.Members must qualify for and complete all activities to receive $500 or more. Login to your member portal at …Contact us at 1-877-687-1196 and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by .... So, to make working with us easier, we develoWith the market and the broader economy po All the health plans offered on the Health Insurance Marketplace include certain items or services, or Essential Health Benefits (EHBs). 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. In the ever-evolving landscape of healthcare, it is esse Beginning January 1, 2021, Ambetter from Superior HealthPlan is pleased to announce we are expanding our partnership with National Imaging Associates, Inc. (NIA) to include utilization review of outpatient rehabilitative and habilitative therapy services on behalf of Ambetter. This program includes prior authorization for physical, occupational ...For Providers. Note: If you are seeing an Ambetter member who resides in another state, they will not show up in the provider portal. Our customer call center at 1-833-709-4735 can verify eligibility and benefits for any out-of-state members for you. The call center staff can be reached between 8 AM and 5 PM. Ambetter Health can help. You can count on us to share helpful inf...
Continue Reading