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Prior Authorization of Health-Care Services

Superior members have access to all Medicaid and CHIP covered benefits that are medically necessary health-care services. Some of these services need to be reviewed before the service is provided to make sure the service is appropriate and medically necessary. This review is called prior authorization, and is made by doctors, nurses and other health-care professionals. If a prior authorization request cannot be approved based on medical necessity, you will receive a letter with the reason why the prior authorization request was not approved. This is called an adverse determination (medical necessity denial). You can ask Superior to review the prior authorization request again. This is called an appeal of the adverse determination. 

A list of the Medicaid and CHIP covered services that require prior authorization may be found by visiting:

CHIP prior authorization approval and denial rates for the medical care or health-care services may be accessed by visiting:

To review the Medicaid prior authorization annual review report, please reference:

Health-care providers are responsible for submitting prior authorization requests. These requests can be submitted by phone, fax or online, using Superior’s Secure Provider PortalYour provider can also get more information by visiting Superior’s Medicaid and CHIP Prior Authorization Requirements webpage.

Review the information below to learn more about which services may need prior authorization approval before the service is provided. If you have any questions, please call Member Services (Monday-Friday, 8 a.m. – 5 p.m.):

  • CHIP: 1-800-783-5386
  • STAR: 1-800-783-5386
  • STAR Health: 1-866-912-6283
  • STAR Kids: 1-844-590-4883
  • STAR+PLUS: 1-877-277-9772