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The following are services that may require a referral from your PCP: Specialist services, including standing or ongoing referrals to a specific provider. Diagnostic tests (X-ray and lab) High tech imaging (CT scans, MRIs, PET scans, etc.)*. Planned inpatient admission*. Clinic services. Renal dialysis (kidney disease)*.If you are already contracted with Superior, please visit the Add a Product page and complete the online form to add Ambetter to your contract. Required fields are marked with an asterisk (*) The form fields are loading, please wait. Thank you for your interest in becoming a network provider with Ambetter from Superior HealthPlan. If you would ...• Ambetter from Superior HealthPlan (Ambetter Health) provides market-leading, affordable health insurance on the Health Insurance ... – This can be done through the Secure Provider Portal. Ambetter Health Silver and Gold Note: Possession of an ID Card does not guarantee eligibility and benefits.<link rel="stylesheet" href="https://d27jsq48o3jhm9.cloudfront.net/ambetter/assets/css/dpe-noscript.css" />Nurse Advice Line. We make it possible for you to talk to a registered nurse at any time—24 hours a day, 7 days a week, 365 days a year. Our nurse advice line helps you and your family receive the care you need, when you need it. It's staffed with experienced nurses who are ready and eager to help you. You can call our nurse advice line ...Access Daily Patient Lists from One Screen. One concise view allows primary care providers to scan patient lists for Ambetter from Meridian member eligibility, care gaps, and much more. Manage Batch Claims for Free. Submit and manage claims, including batch files, for free. View detailed Electronic Funds Transfer (EFT) payment history.Ambetter from Superior HealthPlan offers a provider resource toolkit so you can focus on providing care. Learn more about our health insurance provider support.Pay By Phone. Call Ambetter Health billing services to pay by phone. Pay using our Interactive Voice Response (IVR) system. Or if you need help, talk to a representative at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989 ). For Additional Ways to Pay, by mail or MoneyGram®, log into your member account or look on the back of your invoice to ...If you need help finding a pharmacy, please call Member Services at 1-877-687-1196. Relay Texas/TTY users should call 1-800-735-2989. More on Ambetter Health's pharmacy program. Use our Preferred Drug List (Formulary) to find more information on the drugs that Ambetter Health covers. 2024 Formulary/Prescription Drug List (PDF)So, to make working with us easier, we developed the Provider Toolkit webpage. It’s designed to provide you with valuable education and materials to simplify your administrative responsibilities—so you can focus on providing care. Provider Toolkits. Ambetter from Superior HealthPlan Provider Toolkit; Medicaid Provider Toolkit (PDF)QUICK REFERENCE GUIDE. General Information. Ambetter from Superior HealthPlan is our new commercial HMO plan in the Texas Health Insurance Marketplace. Ambetter is not a Medicaid plan. Provider and Member Services. Monday through Friday 8 a.m. - 6 p.m. CST. Phone: 1-877-687-1196 or Relay Texas (TDD/TTY) 1-800-735-2989.Live-agent chat is the easiest and fastest way to get real-time support for an array of topics, including: You can even print your chat history to reference later! We encourage you to take advantage of this easy-to-use feature. If you are having difficulties registering please click the "Chat with an Agent" button to receive assistance.QUICK REFERENCE GUIDE. General Information. Ambetter from Superior HealthPlan is our new commercial HMO plan in the Texas Health Insurance Marketplace. Ambetter is not a Medicaid plan. Provider and Member Services. Monday through Friday 8 a.m. – 6 p.m. CST. Phone: 1-877-687-1196 or Relay Texas (TDD/TTY) 1-800-735-2989.You can also reach us from 8am-8pm CST at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989 ). There are many ways to get in touch with us, and resources available on our website: If you have a question about Ambetter from Superior HealthPlan or your affordable health insurance coverage, please contact us. Give us a call or reach us through your ...Members or providers can submit a drug exception request to us by contacting Member Services at 1-877-687-1196 (Relay Texas/TTY 1-800-735-2989) or by sending a written request to the following address: Ambetter from Superior HealthPlan. Attn: Member Services.Behavioral Health Requests/Medical Records: Fax. 844-307-4442. Transplant: Fax. 833-589-240 1. OUTPATIENT ... REQUESTING PROVIDER INFORMATION *Requesting NPI *Requesting . TIN. Requesting Provider Contact Name ... Ambetter from Superior Healthplan Subject: Outpatient Authorization Form Keywords: outpatient, determination, member, servicing ...Call us toll-free at the number on the back of your Superior member ID card. (TTY 1-800-735-2989) Medical professionals can answer your health questions and help set up doctor appointments. Call for: Help caring for a sick child; Help knowing if you should see your Primary Care Provider; Answers to questions about your healthEffective June 15, 2021: Payment Policy - Non-obstetrical and Obstetrical Transabdominal and Transvaginal Ultrasounds. Date: 03/19/21. Superior HealthPlan presents a revised payment policy to communicate the reimbursement criteria for transabdominal and transvaginal ultrasound services. As a result, the following policy has been added, and is ...3900 North 10th Street, Suite 700. McAllen, Texas 78501. Contact. Phone: 1-877-278-4268, select your language and then Option 3 for Account Management. Fax: 1-866-390-1892. Email: [email protected]. Counties covered through this office. Hidalgo SDA: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy ...More information on how to choose a PCP can be found in your member handbook. To find out which nursing facilities are in Superior's network, you can call us at 1-877-277-9772 or search our Find a Provider online tool. If you are a STAR Kids or STAR+PLUS member and are dual eligible, Medicare pays your doctor.Use this form as part of the Ambetter from Superior Healthplan Request for Reconsideration and Claim Dispute process. Request for Reconsideration (Level I) is a communication from the provider about a disagreement with the manner in which a claim was processed. Claim Dispute (Level II) should be used only when a provider has …Contact us at 1-877-687-1196 and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. You will only be able to purchase public transportation directly from the agency either in-person or online.Are you a member of Kaiser Permanente and want to access your health information conveniently? Look no further than kp.org member login. This user-friendly online portal provides y...AUSTIN, Texas (Nov. 15, 2021) – Open Enrollment for the Health Insurance Marketplace in Texas runs through January 15, 2022. Next year, Ambetter from Superior HealthPlan will be offered to Texas residents in seven additional counties, making the program available in 145 counties in the state through the Health Insurance Marketplace.Access Daily Patient Lists from One Screen. One concise view allows primary care providers to scan patient lists for Ambetter from Meridian member eligibility, care gaps, and much more. Manage Batch Claims for Free. Submit and manage claims, including batch files, for free. View detailed Electronic Funds Transfer (EFT) payment history.Coverage Area Map. Get complete healthcare coverage in Texas with Ambetter from Superior HealthPlan. Check out the map below to see where we offer our Marketplace plans. Find coverage in your area. Call us today at 1-877-687-1196 ( Relay Texas/TTY 1-800-735-2989 ).A complaint is an expression of dissatisfaction communicated by a complainant, orally or in writing, about any matter related to Superior, other than an action/adverse determination. As provided by 42 C.F.R. §438.400, possible subjects for complaints include, but are not limited to: The failure to respect the Medicaid member’s rights.myStrength partners with over 140 of the largest healthcare payers and providers in the US, to extend evidence-based behavioral health access to covered members, promoting higher levels of engagement and satisfaction, improved outcomes and reduced cost of care delivery.Pharmacy Program. Ambetter from Superior HealthPlan is committed to providing appropriate, high quality, and cost effective drug therapy to all Ambetter from Superior HealthPlan members. Ambetter from Superior HealthPlan works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered.Superior HealthPlan provides quality Medicaid and CHIP health insurance to members across Texas. If you have STAR or CHIP coverage, call 1-800-783-5386 to speak with a Superior HealthPlan representative. If you have any other type of coverage from Superior, you can find the right phone number below to get in touch with the right team.Healthy partnerships are our specialty. With Ambetter Health, you can rely on the services and support that you need to deliver the best quality of patient care. You're dedicated to your patients, so we're dedicated to you. When you partner with us, you benefit from years of valuable healthcare industry experience and knowledge.Effective August 1, 2024: Pharmacy and Biopharmacy Policies. Date: 05/24/24. 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 ...Create Your Own Account. Create your own health plan account online today! Superior has many convenient and secure tools to assist you and give you access to better health-care information. To enter our secure portal, click on the login button. A new window will open. You will be able to login or register.Credentialing/Network Status. Claims. Request for adding/deleting physicians to an existing group. Providers are able to access real time assistance for their service needs, Monday – Friday, 8:00 a.m. – 5:00 p.m. CST, by calling Provider Services at 1-877-687-1196.Visit the CDC for the most up-to-date information on coronavirus. Please visit your state or county site for update-to-date COVID-19 information in your local community. Ambetter will cover COVID-19 related testing at no cost to you. You do not need prior authorization. Ambetter members can also get COVID-19 Home Testing Kits at no cost.Ambetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, Inc. These companies are each Qualified Health Plan issuers in the Texas Health Insurance Marketplace. This is a solicitation for insurance. ©2024 Celtic Ins. Expand ...By communicating with Superior HealthPlan via email, you give consent to receive information from Superior, which may contain Protected Health Information (PHI), to your email address. This consent is not required. Communication via email is not as secure as communicating via our secure member or provider portal.Ambetter from Superior HealthPlan— your partner for success. Ambetter from Superior HealthPlan is Centene Corporation ‘s Health Insurance Marketplace product. Ambetter Health exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Our approach is based on the core belief that quality healthcare ...Ambetter Health offers affordable health insurance plans that fit your needs and budget. You can shop and compare plans, find a doctor, access telehealth services, and earn rewards for healthy choices. Learn more about Ambetter Health and how to enroll today.EntryKeyID - AuthenticationAmbetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, Inc. These companies are each Qualified Health Plan issuers in the Texas Health Insurance Marketplace. This is a solicitation for insurance. ©2024 Celtic Ins. Expand ...EntryKeyID - AuthenticationTo submit a prior authorization Login Here. To access prior authorization lists, please visit Superior's Prior Authorization Requirements webpage. To access Superior clinical and payment policies, visit Clinical & Payment Polices . Find out if you need a Medicare pre-authorization with Superior HealthPlan's easy Pre Auth Needed Tool.More information on how to choose a PCP can be found in your member handbook. To find out which nursing facilities are in Superior's network, you can call us at 1-877-277-9772 or search our Find a Provider online tool. If you are a STAR Kids or STAR+PLUS member and are dual eligible, Medicare pays your doctor.Ambetter Virtual Access Plans. Our Ambetter Virtual Access plans provide you with a virtual primary care experience. With this plan, you can enjoy the convenience of a Primary Care Provider (PCP) no matter where you are. The PCP can order labs, imaging, write prescriptions, and make referrals for on-the-ground care as needed.Ambetter Virtual Access Plans. We also offer a state-mandated plan that includes all required benefits. If you are interested in learning more about this plan, please call Member Services at 1-877-687-1196 (Relay Texas/TTY: 1-800-735-2989) 8 a.m. to 8 p.m. CST, Monday through Friday or email [email protected] Provider Direct - LoginReference Materials. 2024 Provider and Billing Manual (PDF) 2023 Provider and Billing Manual (PDF) Quick Reference Guide (PDF) ICD-10 Information. External Link. Payspan (PDF) Secure Portal (PDF) Non-Formulary And Step Therapy Exception Request Form (PDF)...

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