For Providers
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If you are a contracted Superior HealthPlan provider, you can register now. If you are a non-contracted provider, you will be able to register after you submit your first claim.
Once you have created an account, you can use the Superior HealthPlan provider portal to:
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient list
- Login/Register
Join Our Network
Thank you for your interest in becoming a Superior HealthPlan network provider. We look forward to working with you to improve the health of the community.
Login
If you are a contracted Superior HealthPlan provider, you can register now to access one of the secure provider portals linked below. If you are a non-contracted provider, you will be able to register after you submit your first claim.
Once you have created an account, you can use the Superior HealthPlan secure provider portal to:
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient list
- Login/Register
Join Our Network
Thank you for your interest in becoming a Superior HealthPlan network provider. We look forward to working with you to improve the health of the community.
Provider Quick Links
Click Here to Contact Your Account Manager
Contact Provider Services:
Contact Provider Services for information or questions on benefits, claims, authorizations and billing inquiries.
In order to expedite your call, please have the following: Tax Identification number, NPI, member ID, DOB, billed amount and date of service available.
Ambetter from Superior HealthPlan
1-877-687-1196
CHIP, CHIP RSA, STAR, STAR+PLUS, STAR+PLUS MMP, STAR Kids and Medicare Advantage
1-877-391-5921
STAR Health (Foster Care)
1-877-391-5921
Office Hours: 8:00 a.m. to 5:00 p.m. CST / 8:00 a.m. to 6:00 p.m. CST (STAR Health only)
After office hours, Superior’s STAR Kids nurse advice line staff is available to answer questions and intake requests for prior authorization by calling 1-844-590-4883.
Have a comment or question? Please Contact Us
Please note: If one of Superior’s web-based systems or provider is unavailable or having technical issues, a notice will be posted on Superior’s website under Provider News.
Provider News
March
Effective April 1, 2025: Removal of Prior Authorization Requirement for Certain Sleep Studies
03/24/25
Effective April 1, 2025, Superior HealthPlan will no longer require prior authorization for certain procedures related to Sleep Studies.Members Rate Their Provider Experience
03/24/25
Each year, Superior HealthPlan conducts five Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys for Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, STAR+PLUS Medicare Medicaid Plan (MMP), Wellcare By Allwell (HMO and HMO DSNP) and Ambetter from Superior HealthPlan members.Important: Account Management Department Name Change
03/21/25
To better align with the terminology used in our Provider Satisfaction Survey and ensure clarity in our communications, we are updating the title of Superior HealthPlan's Account Managers to Provider Representatives. This change is effective immediately.Effective April 1, 2025: Pharmacy and Biopharmacy Policies
03/21/25
Superior HealthPlan has added, updated or retired certain pharmacy and biopharmacy policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result, the following policies are effective on April 1, 2025, at 12:00AM.Effective June 1, 2025: Pharmacy and Biopharmacy Policies
03/21/25
Superior HealthPlan has added, updated or retired certain pharmacy and biopharmacy policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result, the following policies are effective on June 1, 2025, at 12:00AM.Effective 5/1/25: HHSC Revisions to the Uniform Opioid Policy
03/20/25
Superior HealthPlan follows the Texas Health and Human Services Commission (HHSC) Uniformed Managed Care Manual (UMCM) rules. HHSC is updating the Uniform Opioid Policy in UMCM Chapter 16.1 to address Centers for Medicare and Medicaid Services (CMS) compliance.Important Resources for Providers
03/19/25
Superior HealthPlan’s Provider Representatives (formerly known as Account Managers) continue to focus on strengthening our relationships with our providers. In alignment with this goal, Superior’s Provider Representatives can assist with Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, Ambetter from Superior HealthPlan, Wellcare By Allwell and Wellcare needs.3/12/25 UPDATE: HHSC EVV Policy Handbook Revisions
03/18/25
Superior HealthPlan would like to inform providers that The Texas Health and Human Service Commission (HHSC) Electronic Visit Verification (EVV) Policy Handbook has been revised as of March 12, 2025.Effective April 7, 2025: Pharmacy Coverage Updates for COVID-19 Test Kits and Vaccines
03/13/25
Superior HealthPlan would like to inform providers of the following upcoming changes for COVID-19 Test Kits and Vaccines:REQUIRED: After-Hours, Appointment and Office Site Standards
03/10/25
As a reminder, Superior HealthPlan conducts regular assessments to ensure network providers are meeting the after-hours coverage standards required by the Texas Health and Human Services Commission (HHSC). In-network Primary Care Providers (PCPs) are required to provide access to care and medical advice for enrolled members 24 hours per day, 7 days per week.