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Provider News & Information

Subscribe to Superior's Provider Newsflash

Don't miss important provider news and updates! Superior's Provider Newsflash is an e-newsletter emailed every two weeks to subscribing providers. Providers can receive customized news updates from Superior relevant to their region, specialty or Superior products.

Customized news may include, but is not limited to:

  • Mandatory trainings
  • Billing and claims information
  • Texas Health and Human Services (HHS) requirements
  • Superior policy updates

Subscribe or Update Your Information Now!
  • COVID-19: Vaccine Billing and Testing Guidelines
  • NOW AVAILABLE: Person Centered Thinking TrainingTraining Requirement: Model of Care
  • Training Requirement: Model of Care
  • Do Your Members Understand Their Rights and Responsibilities?
  • Helping Texas Communities Thrive

March 23, 2021 Provider Newsflash

  • New SUD Program to Support Members
  • Effective 5/17: Prior Authorization Updates for Therapy Services
  • Monitoring Needed for Members Taking Antipsychotics
  • Potentially Harmful Drug-Disease Interactions
  • Access Behavioral Health Tools

March 9, 2021 Provider Newsflash

  • Updated PA Requirements for Cardiac Surgeries
  • New ENT Surgery and Sleep Study Program
  • NEW: 2021 Superior Hospital POD
  • Member Survey Results on Their Provider Experience
  • GUIDE AVAILABLE: Reducing Side Effects from Antidepressants 
  • Effective March 1, 2021: Pharmacy and Biopharmacy Policies
  • Effective March 12, 2021: Pharmacy and Biopharmacy Policies
  • Effective May 3, 2021: Pharmacy and Biopharmacy Policies

February 23, 2021 Provider Newsflash

  • NEW: Prior Auth Forms and Fax Lines
  • Effective 1/1: Formulary and Prescription Alternatives Updates
  • BILLING: Prohibited Practice
  • Claim Billing Guidelines for PA Requirements
  • CMEs Available for Upcoming Child Psychiatry Access Network Webinars

February 9, 2021 Provider Newsflash

  • REIMBURSEMENT UPDATES: Telemedicine and Telehealth
  • Provider Incentive Program
  • NEW: Durable Medical Equipment Provider Partnership
  • Cervical Cancer Reporting and Prevention
  • VIDEO: STAR Health Success
  • Effective February 1, 2021: Pharmacy and Biopharmacy Policies
  • Effective April 1, 2021: Clinical Policies
  • Effective April 1, 2021: Pharmacy and Biopharmacy Policies

January 27, 2021 Provider Newsflash

  • NEW REQUIREMENT: Controlled Substances
  • Annual Training Requirement
  • REQUIRED: Demographic Updates
  • Helpful Tips for Risk Adjustment
  • DON’T MISS: Valuable Provider Resources

January 12, 2021 Provider Newsflash

  • Requirements to Administer COVID-19 Vaccine
  • COVID-19 Vaccine Information and Resources
  • PA Requirement for Biologic DMARDs
  • HHS Enhanced Postpartum Care Services
  • EASY ACCESS: Valuable Provider Resources
  • Effective December 1, 2020: Pharmacy and Biopharmacy Policies
  • Effective January 15, 2021: Pharmacy and Biopharmacy Policies
  • Effective Feburary 1, 2021: Pharmacy and Biopharmacy Policies
  • Effective February 15, 2021: Clinical Policies
  • Effective March 1, 2021: Pharmacy and Biopharmacy Policies
     

December 8, 2020 Provider Newsflash

  • Prior Auth Requirement: Home Telemonitoring
  • NEW: Provider Accessibility Initiative
  • Effective 1/1: Therapy Prior Auth Requirements
  • Help Reduce Side Effects from Antidepressants
  • Authorization, Risks and Use: Proton Pump Inhibitors
  • Effective December 1, 2020: Pharmacy and Biopharmacy Policies
  • Effective February 1, 2021: Pharmacy and Biopharmacy Policies

November 4, 2020 Provider Newsflash

  • NEW: COVID-19 Procedure Codes
  • INCENTIVES AVAILABLE: Join Project ECHO
  • UPDATES: Prior Authorization Requirements
  • DMARD Therapy Tip Sheets Available 
  • Effective 1/1: New Authorization Requirements
  • Effective January 18, 2021: Pharmacy and Biopharmacy Policies

November 10, 2020 Provider Newsflash

  • Medication Prior Authorization Requirements, Processing and Limits
  • When It Comes to the Flu, You Call the Shots
  • Potentially Harmful Drug-Disease Interactions
  • BILLING: Prohibited Practice
  • Antibiotic Awareness Week
  • Effective November 10, 2020: Pharmacy and Biopharmacy Policies
  • Effective November 30, 2020: Clinical Policies

October 27, 2020 Provider Newsflash

  • REQUIRED: Appointment and Office Site Standards
  • Updated Billing Requirements
  • Open Enrollment Begins November 1
  • REMINDER: Required Model of Care Training
  • CE Credits Available: Reducing Stigma Associated with Opioid Use Disorder
  • Effective January 15, 2021: Payment Policy - Multiple Procedure Payment Reduction (MPPR) for Diagnostic Cardiovascular Procedures

October 13, 2020 Provider Newsflash

  • NEW HHS REQUIREMENT: Personal Care Services Oversight
  • DEADLINE: Open Enrollment 
  • IMPROVEMENT INITIATIVES: Model of Care
  • Monitoring Needed for Members Taking Antipsychotics
  • DON’T MISS: Drug Take Back Day
  • Effective October 30, 2020: Clinical Policies
  • Effective October 6, 2020: Pharmacy and Biopharmacy Policies
  • Effective January 1, 2021: Pharmacy and Biopharmacy Policies
  • Clinical Payment Policy: Polymerase Chain Reaction Respiratory Viral Panel Testing - Effective January 15, 2021

September 29, 2020 Provider Newsflash

  • NEW: 2020-2021 Flu Testing and Treatment
  • NOTICE: Admission Record Requirement
  • Opioid Toolkit: Naloxone Resources
  • Utilization Review Process: What You Need to Know
  • COMPLETE SURVEY BY 10/16
  • Effective November 17, 2020: Pharmacy and Biopharmacy Policies

September 15, 2020 Provider Newsflash

  • Flu Billing Codes and Recommendations
  • Cultural Competency Resources and Language Services Available
  • NOW AVAILABLE: Continuing Education Resources for Adults and Children
  • RECALL: Metformin Tablets
  • Reduce High Anticholinergic Burden (ACB) Scores
  • Effective September 16, 2020: Pharmacy and Biopharmacy Policies

September 1, 2020 Provider Newsflash

  • ACTION REQUIRED: Rate Enhancement
  • Requirements for STAR+PLUS and MMP Services
  • Requirements for STAR Kids and STAR Health Services
  • Improving Health through Quality Improvement
  • Pharmacy Guide: Auth Requirements, Formularies and Quantity Limits
  • Effective October 1, 2020: Clinical Policies

August 18, 2020 Provider Newsflash

  • PROHIBITED: Balance Billing 
  • DUE 8/28: Application for Provider Relief Fund
  • Provider Satisfaction Survey Feedback Creates Change 
  • EFFECTIVE 9/1: New Opioid Policy
  • IMMUNIZATIONS: Important Information and Resources
  • Attention Deficit Hyperactivity Disorder Assessment and Treatment Policy Update - Effective 11/1/20
  • Allergy Testing and Therapy Policy Update - Effective 11/01/20

August 4, 2020 Provider Newsflash

  • HHS Requirement: Private Duty Nursing Prior Authorization Form
  • Policies Effective September 
  • Increase for COVID-19 Treatment Services 
  • ALERT: High-Risk Medications
  • PROVIDER INCENTIVES: Medication Management

July 21, 2020 Provider Newsflash

  • Effective 10/1: New Ambetter Auth Requirements
  • Potentially Harmful Drug-Disease Interactions
  • New Features: Texas Health Passport
  • REQUIREMENT: Model of Care Training
  • Are You Missing Important Updates?

July 7, 2020 Provider Newflash

  • CLAIM REQUIREMENTS
  • Requirement for Ventilators
  • Prior Authorization Approval Notice
  • 2021 Practice Guidelines: Your Feedback is Needed
  • July 2020: New Drugs Requiring Utilization Management

June 23, 2020 Provider Newsflash

  • New TDI Rule: Billing Protections
  • Senate Bill 1264: What Providers Need to Know
  • Continuing Education Trainings Available
  • TEXAS LAW: Abuse, Neglect and Exploitation Reporting
  • Surveys to Improve Member and Provider Satisfaction

June 9, 2020 Provider Newsflash

  • Rejected Claims and Timely Claim Filing
  • PREPARE NOW: EVV Practice Period 
  • HHS Housing Choice 
  • Disease Management for Your Patients
  • Medication Management for Antidepressants
  • COVID-19: Actions for Providers
  • PROHIBITED: Balance Billing
  • Submit Correct Prior Authorization Forms
  • NEW CHECKLIST: Prior Auth Requests
  • PROVIDER INCENTIVES: Medication Management 

May 12, 2020 Provider Newsflash

  • May 2020: New Drugs Requiring Utilization Management
  • NEW: EVV Portal Improvements
  • Extended Suspension of Face-to-Face Activities
  • ACCESS RESOURCES: Social Determinants of Health
  • COVID-19 Webinar: Provider Accessibility 

April 28, 2020 Provider Newsflash

  • COVID-19, BILLING & CLAIMS INFORMATION: Customized to You
  • COVID-19 Support for Grant Writing and Small Business Loan Applications
  • 7/1 DATE EXTENSION: Retrospective Utilization Review of Behavioral Health Inpatient Admissions
  • NOTICE: Behavioral Health and Place of Service Code Requirements for Claims
  • Care Management: Helping Providers Assist Members 

April 14, 2020 Provider Newsflash

  • COVID-19: Prior Auth and Benefit Updates
  • REMOVAL: Prior Authorization for Certain Services 
  • Potentially Harmful Drug-Disease Interactions
  • A Guide to Understanding Credentialing
  • Are You Meeting Immunization Requirements? 

March 31, 2020 Provider Newsflash

  • COVID-19: Latest Billing Information and Resources
  • EFFECTIVE 4/15: Wheelchair Prior Auth Update
  • Help Members Understand their Rights and Responsibilities
  • NEW: Immunization Toolkit
  • REQUIREMENT: Model of Care

March 17, 2020 Provider Newsflash

  • COVID-19: Actions and Guidance for Providers  
  • ENROLL NOW: Opioid Treatment Program
  • GET ACCESS NOW: Telemedicine Visit Summaries
  • Behavioral Health Enhancements and Tools
  • ENSURE COMPLIANCE: Medication Management

March 3, 2020 Provider Newsflash

  • Latest Facts about Coronavirus
  • NEW: Prior Authorization Forms and Fax Line Changes
  • PROHIBITED: Balance Billing
  • HHS Trainings: Evidence Based Practices
  • Patient Survey on Their Provider Experience

February 18, 2020 Provider Newsflash

  • New Prior Authorization Timeframe for CPAP and BiPAP
  • Provider Incentive Program
  • Telehealth Survey
  • EFFECTIVE 4/1: New Pharmacy Program
  • Join the Ambetter and Allwell Networks!

February 4, 2020 Provider Newsflash

  • Trauma-Informed Care Alternative Payment Model Launching 2/1
  • Revised Clinical Policy for Therapy Services
  • Effective 5/1: Retrospective Utilization Review
  • Reporting and Prevention Guidelines for Cervical Cancer
  • Superior HealthPlan and WellCare

January 21, 2020 Provider Newsflash

  • HHS Guidelines: Pharmacy Psychotropic Medication
  • REQUIRED: Is Your Information Accurate?
  • EFFECTIVE 1/30: Medicaid PDL Updates
  • Provider Trainings Available
  • VIDEO: Submitting an Institutional Claim

January 7, 2020 Provider Newsflash

  • Want Superior News Customized to Your Practice?
  • Potentially Harmful Drug-Disease Interactions in Older Adults (DDE)
  • Now Available: Care Gap Information 
  • EVV Visit Maintenance: Extension Reminder
  • Ophthalmology Provider Transition 
     

December 10, 2019 Provider Newsflash

  • CLAIM REQUIREMENT: Payer ID
  • Pharmacy Processing Quick Reference Guides
  • AMBETTER PROVIDERS: PPI Treatment Options
  • AVOID DIRECTORY REMOVAL: VERIFY YOUR INFORMATION 
  • PROVIDER RECOGNIZED FOR EXEMPLARY PERFORMANCE

November 26, 2019 Provider Newsflash

  • New: Prior Authorization Forms and Fax Line Changes
  • New: Prior Authorization Forms and Fax Line Changes
  • REQUIREMENTS: Appointment and Office Site Standards 
  • CONTINUING EDUCATION: ONLINE PROVIDER TRAININGS 
  • UPDATE: AMBETTER FEE SCHEDULE 

November 12, 2019 Provider Newsflash

  • ATTENTION: Allwell (Medicare) and MMP Prior Authorization Updates
  • Provider Incentive Program 
  • Screening Requirement for Members with Diabetes
  • DEADLINE APPROACHING: OPEN ENROLLMENT 
  • COMING SOON: ANTIBIOTIC AWARENESS WEEK 

October 29, 2019 Provider Newsflash

  • PROHIBITED: Balance Billing
  • REQUIREMENT: Model of Care Training 
  • Improvement Initiatives for Model of Care
  • HHSC HEALTH ADVISORY: CONGENITAL SYPHILIS 
  • SUPERIOR HEALTHPLAN: 20 YEAR CELEBRATION 

October 15, 2019 Provider Newsflash

  • Effective 1/1/20: New Payment Policy
  • Removal of Prior Authorization Requirements 
  • NEW: Prior Authorization Guidelines for Synagis 
  • DEADLINE: MEDICARE OPEN ENROLLMENT 
  • 10/26: DRUG TAKE-BACK DAY 

October 1, 2019 Provider Newsflash

  • Mandatory Flu Vaccine Billing Codes
  • BILLING REQUIREMENTS: Patient Driven Payment Model
  • Utilization Review Process: What You Need to Know
  • CDC GUIDELINES: FLU TESTING AND TREATMENT 
  • HHSC REQUEST: DELAY EVV START DATE 

September 17, 2019 Provider Newsflash

  • PAYMENT POLICY IMPLEMENTATION: Physician Office Laboratory Testing
  • 9/1: LTSS Enrollment Deadline
  • Cultural and Social Resources to Enhance Member Care
  • AVOID DIRECTORY REMOVAL: VERIFY YOUR INFO 
  • HEALTH ALERT: SEVERE LUNG DISEASE 

September 3, 2019 Provider Newsflash

  • EFFECTIVE 9/1: LTSS Billing Matrix Changes
  • ACTION REQUIRED: Rate Enhancement Program
  • NEW: STAR+PLUS LTSS Rate Guide
  • MEDICARE PROVIDERS: PPI TREATMENT OPTIONS 
  • OVERVIEW: SUPERIOR PROGRAMS AND SERVICES

August 20, 2019 Provider Newsflash

  • DON'T MISS: ONLINE TRAINING TO TREAT OUD
  • August CAAC Meetings: Your Expertise is Requested
  • Join the QIC!
  • DME RENTAL TO PURCHASE CONVERSION
  • REMINDER: CLAIMS REIMBURSEMENT

August 6, 2019 Provider Newsflash

  • Effective 9/1: CentAccount Becomes My Health Pays
  • Ways to Avoid Claim Denials
  • Your Feedback is Important!
  • PROVIDER INCENTIVE PROGRAM! 
  • ATTENTION PROVIDERS: SUPPORT FOR MEMBERS IN EL PASO

July 23, 2019 Provider Newsflash

  • HHSC Releases Statement
  • REQUIRED: CANS 2.0 Assessment
  • 2020 Guidelines: Your Feedback is Needed
  • NEW CE TRAINING AVAILABLE 
  • EFFECTIVE 7/25: MEDICAID PDL UPDATES 

July 19, 2019 Medicaid News

  • Tips to Avoid Claim Denials
  • New: PDL Changes for Proton Pump Inhibitors
  • New Provider Resource: NCQA QRG
  • MUST-HAVE MEDICAID RESOURCES AND TOOLS

July 9, 2019 Provider Newsflash

  • EFFECTIVE 10/1: Surgical Quality and Safety Management Program
  • Medicare Part B Prior Authorization Update
  • REQUIRED: CANS 2.0 Assessment
  • PROVIDER INCENTIVES: MEDICATION MANAGEMENT
  • HOW TO RECEIVE CUSTOMIZED NEWS

June 25, 2019 Provider Newsflash

  • NEW VIDEO: Submit a Professional Claim
  • REQUIRED TRAINING: Model of Care
  • TEXAS LAW: Abuse, Neglect and Exploitation Reporting
  • BILLING CHANGE DRG CODING
  • 9/15 PAYMENT POLICY IMPLEMENTATION

June 11, 2019 Provider Newsflash

  • Billing Requirements to Avoid Claim Denials
  • Helping New Members Understand Their Health Plan
  • Disease Management for Your Patients
  • NEW CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS
  • CME CREDIT AVAILABLE FOR PROVIDERS

May 28, 2019 Provider Newsflash

  • IMPORTANT: Retrospective Review
  • Use of Title XIX Form for Requests
  • NEW APP: Increase Your HPV Vaccination Rates
  • UPDATE: PA SUBMISSION CHANGE
  • INCENTIVE PROGRAM FOR NURSING FACILITY PROVIDERS

May 14, 2019 Provider Newsflash

  • PROHIBITED: Balance Billing
  • Authorization Criteria for Proton Pump Inhibitors
  • Effective 8/14: Prior Auth Requirements
  • HHSC UPDATE: BILLING CHANGES
  • AVOID DENIALS: HEP C TREATEMENT CHECKLIST

April 30, 2019 Provider Newsflash

  • AVOID DENIALS: Same-Day CANS 2.0 Testing
  • IMPORTANT: Billing Requirements 
  • Care Management: Helping Providers Assist Members
  • NEW APP: INCREASE HPV VACCINATION RATES 
  • REQUIRED: KIDNEY HEALTH AND YOUR PATIENTS

April 16, 2019 Provider Newsflash 

  • Prior Auth Submission Change
  • April 27: National Prescription Drug Take-Back Day
  • A Guide to Understanding Credentialing
  • NEW: EVV MOBILE APP
  • REQUIRED: HHSC VALIDATION PROCESS

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