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Access Behavioral Health Tools and Resources

Date: 03/28/23

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:

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. 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.

In order 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.

For any questions or more information, please reach out to your dedicated Account Manager.