Complaint Information & Form

Complaints

We want to help. If you have a complaint, Superior will have an answer to your complaint within thirty (30) days of the date we get your complaint. Most of the time we can help you right away. There is no time limit for filing a complaint with Superior. You can also complain to the Texas Health and Human Services Commission (HHSC) by calling toll-free at 1-800-252-8263.

We want you to tell us about your complaint. We will not be unfair to you because you complained. We want you to be happy with your health plan.

Remember: Superior has staff that speaks English and Spanish. If you speak another language or are hearing impaired and need help, please call Superior Member Services.

For reporting abuse, neglect, or exploitation of children, the elderly or people with disabilities, please visit the Texas Abuse Hotline or call 1-800-252-5400.

Online Complaint Form

Please fill out our online complaint form below and we will get in touch with you shortly.

Complain By Mail or Fax

Download the Member Complaint form (PDF) or Provider Complaint form (PDF), print and mail or fax the completed form to:

Superior HealthPlan
Attn: Complaints Department
5900 E. Ben White Blvd.
Austin, Texas 78741
Fax: 1-866-683-5369

Complain by Phone

You can also call us toll-free to tell us about your problem.
STAR Medicaid 1-800-783-5386
STAR+PLUS Medicaid 1-877-277-9772
STAR Health (Foster Care) 1-866-912-6283
CHIP 1-800-783-5386
STAR+PLUS Medicare-Medicaid Plan (MMP) 1-866-896-1844
STAR Kids 1-844-590-4883
Wellcare By Allwell (HMO SNP) 1-877-935-8023
Wellcare By Allwell (HMO) 1-844-796-6811

For more information about Superior HealthPlan Medicare Advantage complaints and grievances, please click here.

Online Complaint Form

Please note that any field description with an asterisk (*) is required.

Member First Name *

Member Last Name *

Medicaid or CHIP ID Number *

First Name of Person Completing Form *

Last Name of Person Completing Form *

Other (please explain) *

Phone Number *

Street Address *

City *

State *

Zip Code *

Complaint Details

Other (please explain) *

Date Incident Occurred *

Is this complaint is related to Behavioral Health or Medical Health? *

Behavioral Health Medical Health

What is your complaint? *

How can Superior resolve your issue? *

Please submit any relevant documentation to the complaint:

Attachment 1

Attachment 2

Attachment 3

Please note: Some documents may be too large to send through the Online Complaint Form. If you are not able to attach due to size, please send using one of the other options listed above.

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.

If you agree to receive PHI information from Superior via email, please fill out the following field:

Name of Individual Completing this Form * (Member [you], Parent, Caregiver or Legally Authorized Representative of Member)

Provider First Name *

Provider Last Name *

Practice/Clinic/Facility Name *

Other (please explain) *

Provider Email Address *

Provider Phone Number *

Practice Street Address *

Practice City *

Practice State *

Practice Zip Code *

Are you a contracted provider? *

Yes No

NPI Number *

Tax ID Number (TIN) *

Complaint Details

Other (please explain) *

Date Incident Occured * Use Date Format: XX/XX/XXXX

Is this complaint is related to Behavioral Health or Medical Health? *

Behavioral Health Medical Health

What is your complaint? *

How can Superior resolve your issue? *

Please submit any relevant documentation to the complaint:

Attachment 1

Attachment 2

Attachment 3

Please note:

For claims-related complaints only: Claims detail and / or examples are required for a full review of the complaint to be completed.
Some documents may be too large to send through the Online Complaint Form. If you are not able to attach due to size, please send using one of the other options listed above.

This form will send your message to Superior HealthPlan as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with Superior through email, you accept the risks associated thereof. Superior does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at the Member Services number on the back of your Superior ID card to speak directly to a customer service representative.

By communicating with Superior HealthPlan via email, you give consent to receive information from Superior, which may contain PHI, to your email address. This consent is not required. Communication via email is not as secure as communicating via our secure member portal. If you do not want to receive email responses, please let us know.

Medicaid members can also complain to the Texas Health and Human Services Commission (HHSC) by calling toll-free at 1-800-252-8263. Or Medicaid members can send a letter to:

Texas Health and Human Services Commission Health Plan Management – H-320 P.O. Box 85200 Austin, TX 78708-5200 ATTN: Resolution Services

CHIP and CHIP RSA members can also complain to the Texas Department of Insurance (TDI) by calling 1-800-252-3439. Or CHIP members can send a letter to:

Texas Department of Insurance Consumer Protection Mail Code 111-1A P.O. Box 149104 Austin, TX 78714-9104 FAX: 1-512-475-1771

WEB: http://www.tdi.state.tx.us/

E-mail: ConsumerProtection@tdi.state.tx.us

Superior will send you a letter if a requested service is denied or limited. If you disagree with the decision, you may file an appeal. You can appeal the action if you think Superior:

Is stopping coverage for care you think you/your child needs.
Is denying coverage for care you think should be covered.
Has not paid for some or all of a service or a hospital bill.
Limits a request for a covered service.

You, a doctor or someone else acting on your behalf can appeal an action. Or, a Superior Member Services Advocate can help you file an appeal.

You will have thirty (30) days from the date of the denial letter to appeal the decision. Superior will acknowledge your appeal within five (5) days of receipt, and complete the appeal within thirty (30) days. This process can be extended up to fourteen (14) days if you ask for an extension. If more time is needed for Superior to gather facts about the requested service, you will receive a letter with the reason for the delay.

Complaint Information & Form

Complaints

Online Complaint Form

Complain By Mail or Fax

Complain by Phone

Online Complaint Form

STAR, STAR+PLUS AND STAR HEALTH (FOSTER CARE) COMPLAINTS

CHIP AND CHIP RSA COMPLAINTS

APPEAL INFORMATION