Superior Health Plan Provider Certification Form

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Provider Forms Superior HealthPlan

(5 days ago) WEBBehavioral Health Disclosure of Ownership and Control Interest Statement (PDF) Behavioral Health Facility and Ancillary Credentialing Application (PDF) Behavioral …

https://www.superiorhealthplan.com/providers/resources/forms.html

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Individual Provider Contracting Packet - Superior HealthPlan

(2 days ago) WEBSigned and dated Participating Provider Attestation on page 15. Return all documents to: Mail: Superior HealthPlan, ATTN: Contract Management, 7990 Interstate 10 Frontage …

https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_20184499-Individual-Provider-Contracting-Packet-05022018.pdf

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Physician Certification (2601) - Superior HealthPlan

(7 days ago) WEBYes, the medical provider can return the MN electronically or via fax: • Electronically: Adobe Sign e-signature can be used to sign and submit the MN Form. Forms using an …

https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_20206738-MN-Form-FAQ-SK-SH-P-508-10012020.pdf

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Provider Resources, Manuals, and Forms - Ambetter from Superior …

(1 days ago) WEBAmbetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms.html

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SHP - Provider Statement of Need - Superior HealthPlan

(8 days ago) WEBOnce completed, return the form by fax to 1-866-703-0502, or electronically with an Adobe e-Signature to. [email protected]. For any questions, concerns or …

https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_20207117A-PSON-Electronic-Form-SP-MMP-P-508-12092020.pdf

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Resources / Materials - Superior HealthPlan

(9 days ago) WEBSuperior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) recommends all of our plan members take the time to create a living will, designate a …

https://mmp.superiorhealthplan.com/resources.html

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Referral and Authorization Information - Ambetter …

(3 days ago) WEBThe following are services that may require a referral from your PCP: Specialist services, including standing or ongoing referrals to a specific provider. Diagnostic tests (X-ray and lab) High tech imaging (CT scans, …

https://ambetter.superiorhealthplan.com/resources/handbooks-forms/referral-authorization.html

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Prior Authorization Requirements for Health Insurance Marketplace

(6 days ago) WEBContact information for all services that require prior authorization are included below: Prior Authorization Phone Numbers: Physical Health: 1-877-687-1196. Behavioral Health: 1 …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms/prior-authorization-requirements-for-health-insurance-marketplac.html

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Superior HealthPlan Provider Portal & Resources Superior HealthPla

(9 days ago) WEBContact Provider Services: Contact Provider Services for information or questions on benefits, claims, authorizations and billing inquiries. In order to expedite your call, please …

https://www.superiorhealthplan.com/providers.html

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Find a Doctor or Pharmacy - Superior HealthPlan

(4 days ago) WEBYou can use Google Maps within our Find a Provider tool to help you plan the best route for your provider visit. To choose a doctor or Primary Care Provider …

https://mmp.superiorhealthplan.com/benefits/find-a-doctor-or-pharmacy.html

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Pre-Auth Tool Ambetter from Superior HealthPlan

(Just Now) WEBCardiac, Sleep Study Management and Ear, Nose and Throat (ENT) procedures need to be verified by TurningPoint. Please contact TurningPoint by phone (1-855-336-4391) or fax …

https://ambetter.superiorhealthplan.com/provider-resources/manuals-and-forms/pre-auth.html

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SHP - Specialist as PCP Request Form - Ambetter from …

(5 days ago) WEBDate Sent to Provider Services: Referral Authorization Number: 1-877-687-1196 Please fax completed form to Ambetter from Superior HealthPlan, Medical Management at 1-855 …

https://ambetter.superiorhealthplan.com/content/dam/centene/Superior/Ambetter/PDFs/amb-specialist-as-pcp-request-form-508.pdf

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Provider Credentialing Information and Rights

(3 days ago) WEBHow to Release Information. To release this information, a written request must be submitted to Superior’s Credentialing Department at the address or email …

https://www.superiorhealthplan.com/newsroom/provider-credentialing-information-and-rights-05202024.html

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Forms - Ambetter from Superior HealthPlan

(Just Now) WEBAmbetter from Superior HealthPlan includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Superior HealthPlan, …

https://ambetter.superiorhealthplan.com/forms.html

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Credentialing Process Overview - Horizon BCBSNJ

(5 days ago) WEBunique CAQH Provider ID number. Credentialing Forms : All forms that you need to submit with your Application may beaccessed via hyperlinks within the following pages. …

https://www.horizonblue.com/sites/default/files/2020-04/32244_Other_healthcare_professional_checklist.pdf

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Credentialing Process Overview - Horizon BCBSNJ

(5 days ago) WEBOur credentialing process takes approximately. 45 to 90 days. from the date that we have all required information. • We will send you a written response if your Application has …

https://www.horizonblue.com/sites/default/files/2020-04/32214_Physician_checklist.pdf

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LICENSING ORTHONET CLINICAL CRITERIA

(5 days ago) WEBTo do so, follow the instructions to initiate a Stage 1 UM Appeal Review described in the non-certification letter received. For more information, contact the OrthoNet Medical …

https://www.orthonet-online.com/forms/NJ_WEB_NOTICE.pdf

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Superior HealthPlan Medicaid Provider Application Superior …

(7 days ago) WEBCentral Registry Check Request for Abuse/Neglect - Form 1600, for behavioral health foster care providers only. For questions on the credentialing process, please: Email: …

https://www.superiorhealthplan.com/providers/become-a-provider.html

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Mailto: HorizonBCBSNJ GROUPENROLLMENT/CHANGE …

(7 days ago) WEBEmployee enrollment of job or reduction in hours C3. Divorce (COBRA/NJSGC); in Medicare (COBRA C4. Death of C6. Loss of dependent employee civil union dissolution …

https://www.horizonblue.com/sites/default/files/2016-09/Horizon-BCBSNJ-6859-Enrollment-Change-Request-Form-Medical-and-Dental-Mid-Size-and-Large-Groups_1.pdf

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Finding a Provider in the Ambetter Network - Ambetter from …

(9 days ago) WEBYou can also contact Ambetter Member Services through the Online Member Portal, by email at [email protected] or by calling 1-877-687 …

https://ambetter.superiorhealthplan.com/resources/member-news/finding-a-provider-in-the-ambetter-network.html

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IMPORTANT: Updates to the Provider Statement of Need Form

(4 days ago) WEBThe following resources can be found on Superior’s Forms webpage: Provider Statement of Need – STAR Kids and STAR Health (PDF) If you have questions about …

https://www.superiorhealthplan.com/newsroom/important-updates-to-the-provider-statement-of-need-form-05242024.html

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Provider Login Superior HealthPlan

(5 days ago) WEBProviders contracted for Wellcare Complete can login/register here. Secure Web Portal Support. For support while using the web portal, please call 1-866-895-8443 or email …

https://www.superiorhealthplan.com/providers/login.html

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