Request Network Participation, Non-Contracted Providers Only
To ensure your request is processed timely, please submit using the most recent version of Internet Explorer, Chrome, Safari or FireFox.
- Login
-
Find a Provider
- For Members
-
For Providers
- Find My Provider Representative
- Network Request or Update
- Prior Authorization
- Provider Events
-
Provider News & Information
-
Provider Resources
- Behavioral Health
- Care Management
- Clinical, Payment & Pharmacy Policies
- Complaint Procedures
- Coronavirus Updates
- Billing and Coding
- Find My Provider Representative
- Forms
- Health Passport
- Important Websites
- Member Rights and Responsibilities
- Nursing Facilities
- Patient Centered Medical Home Model
- Pharmacy
- Practice Improvement Resource Center (PIRC)
- Community and Provider Grant Program
- Provider Toolkit
- QI Program
- STAR Kids
- Updating Provider Demographic Information
- EPSDT Provider Toolkit
- Secure Portal Login
- Training and Manuals
- Get Insured
- About Superior HealthPlan
- Contact Us
-
Newsroom
- Effective March 1, 2024: Removal of Prior Authorization Requirement for Certain Genetic Procedures
- Pneumococcal 20-Valent Conjugate Vaccine Age Range Expansion
- Updated January 25,2024 : Texas Medicaid Preferred Drug List Updates
- EVV Claims Matching Bypass from January 1 to March 31
- EVV Visit Maintenance Processes on Hold for Dates of Service Prior to Go-Live Date with Current EVV
- Effective March 1, 2024: Pharmacy and Biopharmacy Policies
- Apply Now: Home Health Aide Training Program
- Now Available: HHSC Telemedicine and Telehealth Educational Video and Infographics
- Test
- Test Page January 1, 2024
- 3 in 30 Assessments for Foster Care Patients
- UPDATED: STAR Kids LTSS Billing Matrix
- STAR Health Trauma-Informed Care Alternative Payment Model
- ACTION REQUIRED: Rate Enhancement
- Provider Satisfaction Survey Save the Date
- Medicare Member Plan Benefits Resumed for Applicable COVID-19 Testing, Screening, and Treatment Services
- Effective August 1, 2023: Pharmacy and Biopharmacy Policies
- Medicaid Inpatient Hospital Spell of Illness Policy Extension for COVID-19 Ending
- Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success
- Upcoming Hepatitis C Educational Webinar for Prescribers
- RSV 2022
- Upcoming EVV HHAeXchange Webinar
- Effective May 1, 2024 Pharmacy and Biopharmacy Policies
- Help Protect Your Patients and Your Community Against RSV
- Provider Alert: Change Healthcare Cybersecurity Incident and Its Impact to Superior HealthPlan
- Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP
- Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies
- Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville
- Barrier Removal Fund (BRF) 2022 Initiative
- Provider Notice of Adverse Benefit Determinations
- Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnership’s (TMHP) Eligibility Verification Issues
- Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
- Support for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
- Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies
- Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing
- Training Requirement: Model of Care
- 3 in 30 Assessments for Foster Care Patients
- STAR+PLUS: Contract Award Updates
- EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment
- REQUIRED: After-Hours, Appointment and Office Site Standards
- Availity to Host Live Training Webinars for Providers
- IMPORTANT: Updates to HHAeXchange EVV Training Resources
- Texas-based Superior HealthPlan Releases Annual Community Investment Report
- Effective April 15, 2024: Cranial Molding Orthosis
- Secure Portal: Manage Tasks Quickly and Easily
- Effective March 25, 2024: Clinical Policies
- Effective May 31, 2024: Clinical Policies
- 2023 – 2024 Respiratory Syncytial Virus (RSV) Season Changes
- Effective June 1, 2024: Pharmacy and Biopharmacy Policies
- Effective April 1, 2024: Pharmacy and Biopharmacy Policies
- EVV Visit Transaction Rejection Codes to Begin April 1, 2024
- members-rate-their-provider-experience-03262024
- REQUIRED: Prior Authorization for Nursing Facility Add-On Therapy
- NOW AVAILABLE: HHS Briefing on Change Healthcare
- Drug Take Back April 2024
- Health Passport Requirements for Behavioral Health Providers Serving STAR Health Members
- April 27: Drug Take Back Day
- Resolving Payment Discrepancies on Claims
- Effective 04/22/24: Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies Online Platform
- NEW: Partnership and Appointment Platform with Grow Therapy
- Access Behavioral Health Tools and Resources
- Billing EVV Services as Secondary Insurance Claims
- NEW: Change Healthcare Availity and Zelis Processes
- Updated EVV Home Health Care Services Bill Codes Table
- UPDATED: Timeframe for Clinical Information for Acute Inpatient Facility Providers
- ACTION REQUIRED: CMS Annual Drug Utilization Review Survey for FFY 2023
- PROHIBITED: Balance Billing
- Register for Upcoming LTSS Recruitment and Retention Webinar
- Effective August 1, 2024: Prior Authorization for Certain Genetic Procedure Codes
- Effective May 1, 2024: Pharmacy and Biopharmacy Policies
- ACTION REQUIRED: Confirm Your Provider Information is Accurate
- Attention: Providers in the Travis Service Delivery Area
- Now Available: Trainings for Hospital Providers
- EVV Alternative Device Phase-Out Schedule for Public Comment – Due by May 15
- Effective May 1, 2024: Removal of Prior Authorization Requirement for Certain Medical Eye Procedures
- Updates to the EVV Visit Maintenance Processes Hold for Dates of Service Prior to Go-Live Date
- AcariaHealth Remains In-Network and a Preferred Specialty Pharmacy
- Effective July 1, 2024: Pharmacy and Biopharmacy Policies
- Effective August 1, 2024: Clinical Policies
- Do Your Patients Understand Their Rights and Responsibilities?
- Superior HealthPlan Employees Show Support for March of Dimes in Austin
- Asthma Awareness Month: Inclusion of National Guidelines into Clinical Practice
- Secure Portal: Manage Tasks Quickly and Easily
- ATTENTION LTSS PROVIDERS: 2023 Cost Report Due to HHSC by 5/15
- Provider Credentialing Information and Rights
- EVV Compliance Grace Period Extended
- Effective August 1, 2024: Pharmacy and Biopharmacy Policies
- Effective June 1, 2024: Pharmacy and Biopharmacy Policies
- Effective May 22, 2024: Clinical Policies
- Effective May 27, 2024: Clinical Policies
- Effective June 28, 2024: Clinical Policies
- Effective July 31, 2024: Clinical Policies
- Effective June 1, 2024: Revised Payment Policy: Code Editing Overview
- Ascension Cybersecurity Incident Provider Accommodations
- Provider Training Opportunities and Special Events
- EVV PSO 2024 Onboarding Schedule and Enrollment Information
- IMPORTANT: Updates to the Provider Statement of Need Form
- 3 in 30 Assessments for Foster Care Patients
- HHSC STAR+PLUS Upcoming Webinars
- June 13: Hepatitis C Webinar for Prescribers
- Care Management: Helping Providers Assist Superior Members
- Effective 9/1: STAR+PLUS Contract Changes
- 2024 EVV Proprietary System Request Form Submission Deadline July 15, 2024
- Adding Behavioral Health Providers to Maternal Mental Health Treatment Network
- Training Requirement: Model of Care
- Effective July 1, 2024: Pharmacy and Biopharmacy Policies
- Effective September 1, 2024: Pharmacy and Biopharmacy Policies
- IMPORTANT: Billing Notice to Behavioral Health Providers
- 2023 Cost Report Training Information for LTSS Providers
- Effective October 1, 2024: Prior Authorization Update for New CPT Codes
- Reminder: EVV Home Phone Landline Requirements
- Effective June 1, 2024: Elimination of Certain Laboratory Services Payment Policies
- Effective 10/1/24: Co-pays will Resume for CHIP COVID-19 Services
- IMPORTANT: Medical Records Retrieval Project
- Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics
- Important Cultural Competency, Health Equity and NMDOH Resources
- REQUIRED: After-Hours, Appointment and Office Site Standards
- Effective October 31, 2024: Clinical Policies
- Effective September 30, 2024: Clinical Policies
- Effective July 22, 2024: Clinical Policies
- Effective October 1, 2024: Pharmacy and Biopharmacy Policies
- Upcoming LTSS Recruitment and Retention Webinar
- Provider Satisfaction Survey
- Upcoming Provider Satisfaction Survey
- EVV Policy Reminder for Severe Weather
- Effective 9/1/24: Procedure Code Update for Dental Anesthesia Prior Authorization Requests
- Additional 2023 CPC Cost Report Training Information for LTSS Providers
- Effective 10/31/24: Behavioral Health – Substance Use Disorder Treatment Criteria
- Effective 7/25/24: Texas Medicaid Preferred Drug List Updates
- Effective November 11, 2024: Clinical Policies
- New and Revised Clinical Payment Policies and Code Editing Payment Policy Reminder for Marketplace
- Requirements for Claim Submissions
- NEW: Provider Tool for Enhancing Care for those with IDD and Communication Barriers
- Effective 9/1/24: Genetic Services Biomarker Testing
- Tips for your Practice: Chlamydia Screening Recommendations
- Healthcare Resources and Alternatives to Use in Your Practice
- Effective September 1, 2024: Pharmacy and Biopharmacy Policies
- Effective November 1, 2024: Pharmacy and Biopharmacy Policies
- ACTION REQUIRED: Rate Enhancement Affidavit
- IMPORTANT INFORMATION: For Providers in the Bexar SDA
- Effective 9/1/24: Influenza Vaccine Procedure Code Becomes a Benefit of Texas Medicaid
- Improving Health through Quality Improvement
- Clarification: Lumbar Sacral Orthotics Criteria
- Effective 10/1/24: COVID-19 Vaccine Administration Updates for Medicaid and CHIP
- IMPORTANT: STAR+PLUS Authorization for Services that Require the Use of EVV
- IMPORTANT: CDI Upcoming Webinars
- Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
- REMINDER: Updated TAC References in CDS Forms
- HHSC REMINDER: Postpartum Medicaid and CHIP Coverage Extension
- Effective December 1, 2024: Pharmacy and Biopharmacy Policies
- Effective December 1, 2024: Pharmacy and Biopharmacy Policies
- Resource for Members: Pyx Health
- REGISTER NOW: In-Person Trauma-Focused Cognitive Behavioral Therapy Training
- Effective 9/1: STAR+PLUS MCO-to-MCO Transfer of Authorizations
- Effective September 23, 2024: Clinical Policies
- Effective 10/01/24: RSV Vaccine Procedure Code 90683 Becomes a Benefit of Texas Medicaid
- EVV Compliance Grace Period Ends December 31
- NEW: HHSC EVV Policy Handbook Revisions
- 2024-2025 RSV and Synagis® Season Prior Authorization
- Effective November 1, 2024: Pharmacy and Biopharmacy Policies
- Effective January 1, 2025: Pharmacy and Biopharmacy Policies
- Update to Unit Limitations for Certain Medical Supplies
- Effective February 1, 2025: Clinical Policies
- EVV Alternative Device Reduction Schedule
- COPD Awareness Month: Tips, Tools, and Resources
- Reminder: Medicaid Third Party Liability Provider Requirements
- REQUIRED: Adult Foster Care Residential Agreement Checklist
- Effective 12/27/24: OnTrak Partnership Ends
- Effective December 1, 2024: Pharmacy and Biopharmacy Policies
- Effective November 25, 2024: Clinical Policies
- Effective January 31, 2025: Clinical Policies
- Effective 12/1/24: Certain Non-Surgical Services Procedure Codes Updates
- Training Requirement: Model of Care
- REMINDER: EVV Compliance Grace Period Ends December 31
- EVV PSO ORR Sessions Updates
- Effective September 1, 2024: Pharmacy and Biopharmacy Policies
- Effective October 1, 2024: Pharmacy and Biopharmacy Policies
- IMPORTANT: HHSC Medicaid Provider Enrollment Revalidation Flexibilities
- Effective January 1, 2025: Pharmacy and Biopharmacy Policies
- Effective March 1, 2025: Pharmacy and Biopharmacy Policies
- Payment Policy Posting and Updates
- Effective April 1, 2025: Sleep Studies Clinical Policies
- Effective March 31, 2025: New and Revised Clinical Payment Policies
- Notice to Physicians and Providers
- Effective 1/30/2025: Texas Medicaid Preferred Drug List Updates
- 2024 Cost Report Training Information for LTSS Providers
- Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
- IMPORTANT: Post-Service Medical Necessity Appeal Submissions
- 2025 Medicare and MMP Formulary Changes
- Same-Day Texas CANS 3.0 Assessments and Psychological and Neuropsychological Testing for STAR Health
- Medicare Prescription Payment Program
- Effective April 30, 2025: Clinical Policies
- Effective January 27, 2025: Clinical Policies
- Effective March 31, 2025: Clinical Policies
- Effective April 20, 2025: Clinical Policies
- Effective April 20, 2025: Concert Genetic Testing Policies
- Superior HealthPlan Recognized as a Best Place for Working Parents® in Texas
- Effective 4/1/25: HHSC Revisions to the Uniform Opioid Policy
- Effective May 1, 2025: Pharmacy and Biopharmacy Policies
- Effective March 1, 2025: Pharmacy and Biopharmacy Policies
- Effective May 1, 2025: Pharmacy and Biopharmacy Policies
- Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
- Effective March 1, 2025: New Medicaid Benefit - Certified Family Partner Services
- Important Resource for Hospital Providers
- Effective April 7, 2025: Pharmacy Coverage Updates for COVID-19 Test Kits and Vaccines
- 3/12/25 UPDATE: HHSC EVV Policy Handbook Revisions
- Important Resources for Providers
- Effective June 1, 2025: Pharmacy and Biopharmacy Policies
- Effective April 1, 2025: Pharmacy and Biopharmacy Policies
- Effective April 1, 2025: Removal of Prior Authorization Requirement for Certain Sleep Studies
- Members Rate Their Provider Experience
- Effective March 31, 2025: Clinical Policies
- Effective May 30, 2025: Clinical Policies
-
Events
- (In Person) Harris/Jefferson: Provider Advisory Group
- (Webinar) Hospitals Provider Training
- (Webinar) Hospitals Provider Training
- (Webinar) Hospital Flash Trainings - Superior's Secure Portal- Locating an EOP
- (Webinar) Hospitals Flash Trainings-Medical Necessity Appeals
- (Webinar) Hospitals Flash Trainings-Medical Necessity Appeals
- (In Person) Bexar: Provider Advisory Group
- (Webinar) Travis: Provider Advisory Group
- (Webinar) STAR Kids Long-Term Service and Supports (LTSS) Billing Clinic
- (Webinar) Behavioral Health Billing Clinic
- (Webinar) STAR/CHIP/STAR+PLUS
- (Webinar) Superior Medicare-Medicaid Plan (MMP)
- (Webinar) STAR/CHIP/STAR+PLUS
- (Webinar) Cultural Competency and Disability Sensitivity Training
- (Webinar) STAR Kids Long-Term Service and Supports (LTSS) Billing Clinic
- (Webinar) Behavioral Health Billing Clinic
- (Webinar) Wellcare By Allwell (Medicare Advantage)
- (Webinar) Comprehensive Billing Clinic
- (Webinar) Long-Term Service and Supports (LTSS) Billing Clinic
- (Webinar) Ambetter from Superior HealthPlan
- (Webinar) STAR Kids
- (Webinar) Superior Nursing Facility Training
- (Webinar) Electronic Visit Verification (EVV)
- (Webinar) STAR Health
- (Webinar) Northeast: Provider Advisory Group
- Privacy Policy
- Terms & Conditions
- Notice of Privacy Practices
- Supporting Texas Communities