• Geographical Access for Superior Members

    Superior’s goal is to ensure that members have geographic access to diverse and qualified practitioners and health-care options, regardless of where they may reside. Geographic accessibility defines how physically accessible resources are for members, and it ascertains whether members are allotted the right to choose the services and resources they feel best fit their health-care…

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  • HHSC Survey for Home and Community-Based Services Due 7/29

    On March 17, 2014, The Centers for Medicare and Medicaid Services (CMS) issued new regulations with additional requirements for Medicaid-funded Home and Community-Based Services (HCBS), including Medicaid 1115 waiver programs providing such services. Providers must comply with the new rules by March 17, 2019. As part of the transition to the new rules, the Texas…

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  • Payment and Clinical Policies for Medicare and Ambetter Providers

    Medicare – Effective 8/12/16 | Ambetter – Effective 10/12/16: Superior HealthPlan is publishing its Payment and Clinical Policies to inform providers about acceptable billing practices and reimbursement methodologies for certain procedures and services. We will apply these policies as medical claims reimbursement edits within our claims adjudication system. This is in addition to all other reimbursement…

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