If yes, please Contact Your Dedicated Account Manager.
Below, please attach Superior’s Contracting and Credentialing Checklist for Individual Providers (applicable to medical and behavioral health providers) and/or Superior’s Facility and Ancillary Demographic Form (applicable to Ancillary, Long-Term Services and Supports [LTSS] and Nursing Facility providers). To download these documents, please visit Superior’s Provider Forms webpage.
Items in the trash will be permanently removed after 30 days.