Search results with tag "Superior healthplan"
Texas - Superior HealthPlan
ambetter.superiorhealthplan.comAmbetter from Superior Healthplan Attn: Level I - Request for Reconsideration PO Box 5010 Farmington, MO 63640 -5010 Ambetter from Superior Healthplan Attn: Level II – Claim Dispute PO Box 5000 Farmington, MO 63640 -5000
Secure Provider Portal - Superior HealthPlan
staging3.centene.comFor assistance with the Secure Provider Portal, contact Superior’s Web Applications Support Desk at 1-866-895-8443 or email TX.WebApplications@SuperiorHealthPlan.com.
Ambetter from Superior HealthPlan
www.superiorhealthplan.com• Ambetter from Superior HealthPlan is an HMO Benefit Plan. • Members enrolled in Ambetter must use in- network participating providers, except in the case of emergency services. • If an out-of-network provider is used (except in the case of emergency services), the member will be 100% responsible for all charges.
Medicare Advantage HHSC Contract Number CMS Code Plan …
www.tmhp.comSuperior HealthPlan, Inc. HHS000521900001 H5294 007 Allwell Dual Medicare (HMO SNP) SNP Fort Bend, Montgomery. Medicare Advantage Plan MCO HHSC Contract Number CMS Code Plan ID Plan Name Type Counties Served Superior HealthPlan, Inc. HHS000521900001 H5294 009 Allwell Dual Medicare (HMO SNP) SNP Lubbock
Medicare Prior Authorization List Effective January 1, 2021
www.superiorhealthplan.comEffective January 1, 2021 Allwell.SuperiorHealthPlan.com SHP_20207187A . Allwell from Superior HealthPlan (HMO and HMO SNP) requires prior authorization as a condition of payment for many services. This notice contains information regarding prior authorization requirements and is applicable to all Medicare products offered by Allwell.
2021 Prescription Drug List - Superior HealthPlan
ambetter.superiorhealthplan.com2021 Prescription Drug List Effective January 1, 2021. Ambetter.SuperiorHealthPlan.com
Reconsideration Request Form - Superior HealthPlan
www.superiorhealthplan.comCheck box if this Reconsideration Request is for multiple claims. Please attach a separate list if more than one claim number and/or member ID is related to this reconsideration request. Provider Name Provider Tax ID Provider NPI Date of last Explanation of Payment Superior Claim Number* Dates of Service* Member Name* Member ID* *Required fields
REQUEST FOR PRIOR AUTHORIZATION - Superior HealthPlan
www.superiorhealthplan.comAssisted Living Adult Foster Care. Adaptive Aids Emergency Response Services ... Superior requires services be approved before the service is rendered. ... which is not an emergency but is severe or painful enough to require medical treatment evaluation or treatment within 24 hours to prevent serious deterioration of the member’s condition or ...
Summary of Benefits and Coverage: What this Plan Covers ...
api.centene.comAmbetter from Superior HealthPlan: Coverage for: Individual/Family | Plan Type: EPO Ambetter Balanced Care 32. SBC-29418TX0140101-06 Underwritten by Celtic Insurance Company . The Summary of Benefits and Coverage (SBC) document will help you choose a health plan.
Assurance™ EDI - Claim Status Payer List
connectcenter.changehealthcare.comAllwell from Superior HealthPlan CNTENE 7785/8527 No 68069 Real Time No Allwell from Western Sky Community Care CNTENE 1075/8102 No 68069 Real Time No Altius ALTIUS 1837/8538 No SX113 Real Time No Ambetter from Health Net CNTENE 7808/8583 No 68069 Real Time No Ambetter from Homestate Health CNTENE 7809/8584 No 68069 Real Time No ...