Provider Feedback Creates Changes at Superior
Date:
04/13/18
Superior continuously reviews policies and procedures to ensure quality care is delivered to members and provider needs are met. During reviews, provider feedback is crucial to making informed decisions on changes that need to be implemented.
This year, provider feedback has influenced several initiatives to improve provider experience. As a result, changes to Superior policies and procedures have been implemented.
SUPERIOR UPDATES DUE TO PROVIDER FEEDBACK
|
|---|
| DME Reimbursement Restructuring
- Superior suspended the reimbursement restructuring for specific medical supplies for Durable Medical Equipment (DME) providers.
- To learn more, please visit: DME Reimbursement Restructuring
|
| Behavioral Health Individual & Group Therapy Claims for STAR Health
- Effective 3/28/18, Superior began reimbursing behavioral health providers when group and individual psychotherapy services were rendered on the same day.
- For questions, please reach out to your dedicated Account Manager.
|
| Strep/Flu edit
- Superior has recently reviewed our clinical policy Influenza and Streptococcus Group A Testing, and has decided to discontinue this policy. Effective for claims received after March 13, 2018, with a date of service on or after March 1, 2018, Superior will no longer implement the edit denying payment for influenza testing performed on the same date of service as streptococcus testing.
- For questions, please reach out to Provider Services at 1-877-391-5921.
|
| Prior Authorization Removed for SB 58 Defined Services
- Effective March 7, 2018, Case Management (TCM) and Mental Health and Rehabilitation (MHR) (SB 58 defined) services no longer require prior authorization for participating providers, for Medicaid and STAR+PLUS Medicare-Medicaid Plan (MMP).
- To learn more, please visits: Prior Authorization Removed for TCM and MHR Services
|
 | Direct Access to Superior Account Managers
- Providers can now reach Account Management through a direct extension.
- Contact an Account Manager in your area, Monday-Friday, 8 a.m. - 5 p.m., by calling:
- Bexar - 1-866-615-9399, ext. 87390
- Dallas - 1-866-529-0294, ext. 87378
- El Paso - 1-877-391-5923, ext. 87392
- Harris - 1-800-656-4817, ext. 87391
- Hidalgo - 1-877-278-4268, ext. 87394
- Lubbock - 1-866-534-5957, ext. 87393
- Nueces - 1-800-656-4817, ext. 87391
- Travis - 1-800-218-7453, ext. 87395
|
Providers interested in providing feedback on Superior’s policies or procedures are encouraged to contact their Account Manager, or submit an email to SHP.HEDIS@SuperiorHealthPlan.com referencing Practice Guideline Comments in the subject line.
Thank you for being a valued partner with Superior.
