Updating Provider Demographic Information
Having access to accurate provider information is vitally important to Superior members. To ensure a member’s health is not compromised, providers are required to have their contact and demographic information up-to-date. Providers should notify Superior of any changes (ex. address or telephone number updates), if they can no longer accept new patients or are leaving the network. Providers can update the following information through Superior’s Secure Provider Portal:
- Office Address
- Panel Limitations
- Texas Health Steps Status
- Oral Evaluation and Fluoride Varnish (OEFV) Status
- Spoken Languages
In addition to updating information with Superior, providers must also update their enrollment and demographic information with Texas Medicaid & Healthcare Partnership (TMHP). Please ensure your information is updated with TMHP. TMHP is the Texas Health and Human Services (HHS’s) provider enrollment administrator, and serves as the authoritative source for HHS providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with Superior. To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the webpage Provider Enrollment on the Portal - A Step-by-Step Guide.
For instructions on how to make other demographic updates to your current enrollment, please access the document titled Provider Information Management System (PIMS) User Guide (PDF). Otherwise, you can contact TMHP directly at 1-800-925-9126 for assistance.
If a provider decides to leave the Superior network, they must notify Superior as soon as possible. Specific notification timeframes can be found in the provider’s contract or by contacting their local Account Manager. All termination requests must be received in writing and include the provider’s Tax Identification Number (TIN), National Provider Identifier (NPI), termination date and reason for the termination.
Superior is committed to improving continuity of care to ensure that all members have uninterrupted access to health-care services, which is associated with patient satisfaction, better health-care services and lower hospital utilization.
For more information, please review the Superior Provider Manuals found on the Training and Manuals webpage, or call Provider Services at:
- 1-877-391-5921 (STAR, STAR Health, STAR Kids, STAR+PLUS, CHIP, Allwell from Superior HealthPlan and Superior STAR+PLUS Medicare-Medicaid Plan [MMP])
- 1-877-687-1196 (Ambetter from Superior HealthPlan)