Primary Care Provider
Primary Care Providers (PCPs) can help meet the healthcare needs of children in foster care. The PCP works with members, Medical Consenters, caregivers, Superior Service Coordinators and other entities to make sure all the member’s medical and behavioral health needs are met. This includes screenings, referrals and authorizations for services and assessments that impact the member’s health.
Who can serve as a PCP?
Credentialed providers in the following specialties can serve as a PCP:
- Family Practice
- General Practice
- Internal Medicine
- Physician Assistant
- Nurse Practitioner
- Specialist (See below – Specialist as a PCP)
Specialist as a PCP
Superior allows members with chronic, disabling or life-threatening illnesses to apply to Superior’s Medical Director to use a provider contracted and designated as a specialist as their PCP. To be eligible to serve as a PCP, the specialist must meet Superior’s requirements for PCP participation. This includes credentialing and having a contract with Superior as a PCP.
Superior will approve or deny the request for a specialist to serve as a PCP and provide notification of the decision to the member no later than 30 days after receiving the request. When a specialist is approved as a PCP, Superior will provide the non-PCP specialist with a current directory of participating providers.
If the request is denied, the member may appeal the decision through the Superior’s member complaint and appeal process.
You can find a provider online or by calling Member Services at 1-866-912-6283.
You can get your family planning services from your doctor or go to any family planning clinic that takes Medicaid. Superior members can receive family planning services without a referral from their PCP. Call Superior Member Services at 1-866-912-6283 if you need help finding a family planning doctor or clinic.