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Superior Waives Prior Authorization for COVID-19 Related Post-Acute Care through 1/31

Date: 01/08/21

Note: Please view UPDATED: Superior Waives Prior Authorization for COVID-19 Related Post-Acute Care through 2/28 for an updated end date for this guidance.

Due to the surge in COVID-19 cases, Superior HealthPlan will waive COVID-19 related post-acute care Prior Authorization (PA) through January 31, 2021, based on the following terms and conditions:

  • COVID-19 related post-acute care will not require PA; however, Superior does ask providers to notify Superior’s Admissions department via fax at 1-877-650-6942.
    • Authorizations will be approved for the first 3 days for assessment with a determination explanation as directed in documentation systems for tracking.
    • If possible, Superior will perform concurrent review during the member’s post-acute stay. 
    • Standard denial processes will apply if medical necessity criteria are not met.
    • If concurrent review is not possible due to lack of information or due to non-notification of admission, Superior may retrospectively review services at the time of the claim or post-payment to ensure medical necessity.
  • Medical necessity DOES apply and reviews will be conducted based on InterQual/MCG criteria.
    • If the state has issued an emergency declaration, Par/Non-Par requirements will not be enforced during the time that the emergency declaration applies.
    • Superior’s Contracting department will work with Non-Par providers to secure Single Care Agreements.
  • PA, medical necessity requirements and coverage criteria still apply to non-COVID-19 related services unless state regulations require otherwise.

For questions or additional information, contact Superior's Admissions department at 1-855-594-6103.