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Discharge Planning: What Providers Need to Know

Date: 05/24/16

Superior wants to ensure providers understand our prior authorization process for discharge planning. Our goal is to help provide timely and appropriate discharge planning services for a seamless transition from a hospital, emergency room or observation stay to the member’s home setting. Discharge planning services include:

  • Home Health Services
    • Skilled nurse visits
    • Private duty nursing
    • Home health aides
    • Physical therapy
    • Occupational therapy
    • Speech therapy (except STAR+PLUS members who are over 21 and don’t have the Waiver package)
  • Outpatient services
    • Physical therapy, occupational therapy, speech therapy, wound care
  • Durable medical equipment (including supplies)
  • Any other urgent discharge needs for members transitioning in the home setting

Prior authorization requests for discharge planning services for all Superior programs (except STAR+PLUS Dual and STAR+PLUS Dual Waiver), can be made by phone, fax or web.

  • Phone: 1-800-218-7453, ext. 22271 (Medicaid) and ext. 22295 (Medicare)
  • Fax: 1-844-495-2361 (see instructions below)
  • Web: www.SuperiorHealthPlan.com

Please ensure that prior authorization requests for discharge planning services are submitted within 48 hours of discharge from a hospital, emergency room or observation stay. If a member is discharged during non-business hours and/or the weekend, providers should submit discharge planning authorization requests the following business day.

Prior Authorization Fax Requests:

  1. Please visit www.SuperiorHealthPlan.com to download and complete the form.
    • Please include the discharge order from the hospital (signed script, discharge paperwork, electronic or verbal order and Title 19) with your completed prior authorization form. Be sure to provide ICD-10, CPT codes and HCPC codes with frequency, duration and amount of units or visits being requested.
  2. Once the form is completed, please fax your request (form and discharge order) to 1-844-495-2361.
    • On your fax cover sheet and referral form, please write “URGENT DISCHARGE PLANNING.” This will expedite the processing of your request and you will receive authorization within 24 business hours of submission.

For any questions on this information, please feel free to contact Superior’s Discharge Planner at 1-800-218-7453, ext. 22271.