Access Behavioral Health Tools and Resources

Date: 04/08/24

A primary care provider’s role in behavioral health is to coordinate the member’s physical and behavioral health care, including making referrals to behavioral health practitioners when necessary. To ensure providers have what they need to assist members, Superior HealthPlan has resources which offer providers the ability to:

• Find useful behavioral health information, forms and a toolkit on Superior's Behavioral Health webpage.
• Register for behavioral health webinars and trainings on Superior's Provider Training Calendar, as well as Superior's Behavioral Health Clinical Training webpage.
• Help members find behavioral health services and support by contacting Superior’s Behavioral Health department.

Superior’s goals are to provide covered services that are medically necessary, appropriate to the member’s condition, rendered in the appropriate setting and meet professionally-recognized standards of care. To achieve these goals, Superior has the following:

SUPERIOR ENHANCEMENTS TO BEHAVIORAL HEALTH SERVICES
	Direct Access for Providers Dedicated Behavioral Health Utilization Management (UM) team to assist providers and streamline the inpatient notification and authorization request. This allows providers to: Easily request and access authorization information. Contact staff using a dedicated phone number by calling 1-844-842-2537. Obtain authorization using a direct fax line by product and level of care: Inpatient/Concurrent Review 1-844-824-9016 – Ambetter 1-800-732-7562 – Medicaid 1-866-900-6918 – Medicare 1-877-650-6938 – Discharge information Pre-Service Prior Authorization 1-844-307-4442 – Ambetter 1-866-570-7517 – Medicaid 1-855-772-7079 – Medicare
	Medical Director Reviews Maintained board certified psychiatrists to ensure quality reviews.    Supervising Medical Director is an InterQual Certified Instructor.
	A Centralized Appeal Process Maintained a dedicated, centralized behavioral health appeals team within Superior’s UM Appeals Team. Revised the behavioral health appeal processes, to align with Superior’s standardized appeals processes. To review the appeal processes, please review the provider manuals located on Superior’s Provider Training and Manuals webpage.

 

Superior provides behavioral health services to members who need treatment for mental or emotional disorders and substance use disorders, which includes service coordination and care management. Members do not need a referral to access these services. Superior’s fully-integrated approach to managing behavioral and physical health services provides several benefits for members and providers, including:

• An enhanced member experience with centralized medical and behavioral health services and benefits to provide continuity in care.
• A streamlined approach to delivering service and support, with a single point of contact and benefits administration.
• Better experience for your patients
• Improved relationships between offices

To ensure providers can assist members with behavioral health services, Superior is continually working towards making processes easier and more efficient. Together, we can work on a consistent approach towards achieving quality health-care outcomes for your patients. Working collaboratively can be as simple as sharing timely reports or medical records with behavioral health providers that are currently seeing your patients, ensuring follow-up care is scheduled in advance to reduce gap in care, communicate course of treatment and goals to ensure continuity and coordination of care.

For any questions, please contact your Account Manager. To access their contact information visit Find My Account Manager.