UPDATED: Superior Waives Prior Authorization for COVID-19 Related Post-Acute Care through 2/28
Due to the surge in COVID-19 cases, Superior HealthPlan will waive COVID-19 related post-acute care Prior Authorization (PA) through February 28, 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.
*Please note: Previously, the end date for this guidance was January 31, 2021, then extended to February 28, 2021.