QI Program

We are committed to the provision of a well-designed and well-implemented Quality Improvement (QI) program. Our culture, systems and processes are structured around this mission to improve the health of all enrolled members.

Scope

The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to Superior HealthPlan's members including medical, behavioral health, dental and vision care. We incorporate all demographic groups, care settings, and services in QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon Superior HealthPlan's products), and ancillary services.

Goals & Objectives

Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered.

Credentialing Standards and Rights

For consideration to participate in the Superior HealthPlan network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with Superior HealthPlan must complete an application for participation and submit copies of applicable supporting documentation. Each provider must meet minimum qualifications, established by Superior and outlined by NCQA, State licensing agencies and the Texas Department of Insurance (TDI). All providers participating with Superior have the right to:

  • Review information and materials acquired from select primary sources and correct erroneous information.
  • Request the status of credentialing or re-credentialing applications at any time.

For questions, requests or more information, please reach out to Superior’s Credentialing Department at Credentialing@SuperiorHealthPlan.com, call 1-800-820-5686 or fax 1-866-702-4831.

Cultural Competency Plan

Superior HealthPlan is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which Superior HealthPlan can respond to the health care needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language. Our Cultural Competency plan is reviewed and updated annually. 

Participation in QI

Superior HealthPlan requires providers and practitioners to cooperate with all Quality Improvement activities, as well as allow the use of provider and/or practitioner performance data, to ensure the success of the QI Program. The Superior HealthPlan QI Program is outlined in the Superior HealthPlan provider manual, available upon request. If you are interested in learning more about Superior HealthPlan's QI Program, please contact Superior HealthPlan at 1-800-218-7453, ext. 82674 and ask to speak with the Quality Improvement Department.

Superior is dedicated to the provision of a well-designed and well-implemented Quality Assessment and Performance Improvement (QAPI) Program. Superior’s culture, systems and processes are structured around its mission to improve the quality of health-care services for all enrolled members.