Healthcare Resources and Alternatives to Use in Your Practice
Date: 08/16/24
Superior HealthPlan providers should remember the crucial importance of educating members about the value of:
- Telehealth services
- Urgent care facilities
- The significance of scheduling and adhering to appointments with Primary Care Physicians (PCPs)
Encouraging members to explore these alternatives and services rather than opting for Emergency Room (ER) visits can optimize healthcare resources and ensure timely, personalized care. Superior appreciates your dedication to member-centered care. Below are some steps and resources to keep in mind when providing care to Superior members.
Strategies to Reduce Unnecessary ER Visits
- Ensuring the care team is available 24 hours, 7 days a week.
- Offer scheduling options that cater to the needs of members and their families.
- Identify and address barriers to access by Incorporating Non-Medical Drivers of Health (NMDOH) screeners on wellness visits.
- Collaborate with the community, or with Superior’s Care Management or Service Coordination team, to evaluate and address social determinants of health and health disparities by using Superior's Find Help webpage.
- Enhance member access to care through innovative technological solutions. To learn more visit Superior’s Telehealth webpage.
Inform and Educate Members
- Communicate to patients any changes your practice makes to improve access to the care team.
- Reinforce the ways they can interact with your care teams, providing information about when and how to contact them during regular clinic hours and after regular hours.
- Refer members to your care teams or Superior’s Care Management or Service Coordination teams.
- Contact Superior’s Service Coordination team at 1-855-757-6567 or submit a referral request using Superior's Secure Provider Portal.
- Superior Care Managers and Service Coordinators are available to assist with the coordination of a member’s healthcare needs, Monday through Friday from 8:00 a.m. to 5:00 p.m. (CST).
- Contact Superior’s Service Coordination team at 1-855-757-6567 or submit a referral request using Superior's Secure Provider Portal.
Post ER Follow-up and Local Collaboration
- Collaborate and communicate with local ER.
- Participate in Health Information Exchange (HIE).
Resources to Educate and Empower Members
- For transportation needs, share Superior’s Safe-Ride Transportation webpage
- For telehealth services, share Superior’s Telehealth webpage
- For 24/7 Nurse Advice Line support, share the contact information under the Nurse Advice Line section on Superior’s Phone Directory.
- For health education, share Superior’s Krames Online webpage.
- For information on the YES Services Waiver Medicaid program, that helps children and youth with serious mental, emotional and behavioral difficulties, visit HHSC’s YES Waiver webpage.
- For DentaQuest member information, visit DentaQuest’s Member Handbook (PDF).
- For DentaQuest Find A Dentist Provider information, visit DentaQuest’s Find A Dentist webpage.
- For MCNA dental member information, visit MCNA’s Dental Member webpage.
- For assistance in helping a member locate a dental provider, visit MCNA’s Dental Find A Provider STAR webpage.
- For United Dental STAR and CHIP member information, visit United Dental’s Member Handbook webpage.
- For assistance in helping a member locate a medical provider, visit Superior’s Find a Provider webpage.