Copyright 2023 Meridian Health Plan of Michigan, Inc. All rights reserved. All Rights Reserved. Since September 1, 2011, the Online Fee Lookup (OFL) and static fee schedules include a column titled "Adjusted Fee." The Adjusted Fee column displays the fee with all of the percentage reductions applied. The Ambetter from Peach State Health Plan login portal is where you manage your account. With Ambetter, you can rely on the services and support that you need to deliver the best quality of patient care. With Ambetter, you can rely on the services and support that you need to deliver the best quality of patient care. All rights reserved. Your Ambetter online member account puts you in control of your health plan. Superior HealthPlan provides the tools and support you need to deliver the best quality of care. Credentialing myStrength Pharmacy Prior Authorization Quick Reference Guides Training Resources Behavioral Health Toolkit ADHD Resources Alcohol Resources Anxiety Resources You can count on us to share helpful information about COVID, how to prevent it, and recognize its symptoms. Manage patient administrative tasks quickly and easily. Use our tool to see if a pre-authorization is needed. You will need Adobe Reader to open PDFs on this site. And you can access Telehealth on your computer or smart phone anywhere and anytime. Alabama Arizona Arkansas California Florida Georgia Illinois Indiana Kansas Kentucky Louisiana Michigan Mississippi Missouri Nebraska Nevada New Hampshire New Jersey New Mexico $0 Ambetter Telehealth cost share does not apply to HSA plans until the deductible is met. If you dont want to leave our site, choose the X in the upper right corner to close this message. Use your account to view your health plan benefits, check your My Health Pays account balance, request a replacement member ID card and more. What you need to know about the Coronavirus. Shop and Compare Plans; Find a Doctor; Shop and Compare Plans. Just log in. Questions? Make your first payment to access great benefits. Theyve always been able to count on you. AUSTIN, Texas (Nov. 15, 2021) - Open Enrollment for the Health Insurance Marketplace in Texas runs through January 15, 2022. Provider Login; Drug Coverage; Pre-Auth Check; Provider Resources; Clinical and Payment Policies; Provider News; Provider Toolkits; Request Network Participation, Non-Contracted Providers Only, Add a Provider to an Existing Group Contract, Add a Practice Location to an Existing Contract, Practice Improvement Resource Center (PIRC), Updating Provider Demographic Information, Effective 1/1: Electronic Prescribing of Controlled Substances Required, Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP, Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies, Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville, Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success, Provider Notice of Adverse Benefit Determinations, Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnerships (TMHP) Eligibility Verification Issues. Our resources for Texas providers within the Superior network includes the tools and support you need to deliver the best quality of care. Healthcare designed for you. This includes Ambetter Value, a new specialized plan aligned witha select group of primary care providers, which can help guide and steer a members utilization through a referral process. Login Welcome to the Login page. Copyright 2023 Celtic Insurance Company. What is Ambetter? Find everything you need in the member online account. Healthcare is essential. Behavioral Health Effective November 1, 2017, behavioral health functions transitioned from Cenpatico (a subsidiary of Envolve PeopleCare) to Superior HealthPlan. Or use your Aetna Better Healthapp to take your benefits on the go. Simplify Prior Authorization Process Check Patient Care Gaps Additional Features to Streamline Office Operations Get Started Now! Ambetter Health Insurance Plans | Ambetter Home Shop Our Plans Select Your State Find your state below to see Ambetter health insurance plans available in your area. Aetnaprovides infoabout COVID-19on the next page. What is Ambetter from Arizona Complete Health? And, as a partner with Ambetter, youll be able to count on us. For the most updated information or to re-enroll, please visit, Request Network Participation, Non-Contracted Providers Only, Add a Provider to an Existing Group Contract, Add a Practice Location to an Existing Contract, Practice Improvement Resource Center (PIRC), Updating Provider Demographic Information, Effective 1/1: Electronic Prescribing of Controlled Substances Required, Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP, Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies, Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville, Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success, Provider Notice of Adverse Benefit Determinations, Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnerships (TMHP) Eligibility Verification Issues, Ambetter from Superior HealthPlan - Provider Resources, Allwell Qualified Medicare Beneficiaries FAQ (PDF), Balance Billing: Superior Medicaid and CHIP (PDF), Balance Billing: Wellcare By Allwell and STAR+PLUS MMP (PDF), Superior HealthPlan Telemedicine Quick Reference Chart (PDF), TurningPoint Procedure Coding and Medical Policy Information (PDF), Ontrak Program Service Claims - Frequently Asked Questions (PDF), EVV Compliance Job Aid for Consumer Directed Services Employers (PDF), EVV Compliance Job Aid for Program Providers and FMSAs (PDF), EVV Provider Compliance Requirements (PDF), HHS EVV Aggregator and EVV Portal Webinar (PDF), HHS EVV Provider Stakeholder Presentation (PDF), HHS EVV Responsibilities and Additional Information, 1718 Form (PDF), HHS EVV Temporary EVV Policies for Severe Winter Weather (PDF), HHS EVV Temporary Policies for COVID-19 (PDF), HHS EVV Vendor Selection for Cures Act EVV Expansion (PDF), HHS EVV Tool Kit - EVV Visit Maintenance and Transactions (PDF), HHS EVV Tool Kit Module 1 - Introduction to EVV (PDF), HHS EVV Tool Kit Module 2 - 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Medicaid (PDF), Skilled Nursing Requirements Checklist (PDF), Vehicle Modification Request Packet - STAR+PLUS(PDF), Vehicle Modification Request Packet - STAR+PLUS Medicare-Medicaid Plan (MMP)(PDF), Addendum to Billing Methodology for PDN Multiple Ratio with Hospital Admission Event (PDF), Billing Guide for Member to Nurse Ratios (PDF), Medical Criteria, Parameters for Medically Necessary Hours and Exceptions Process (PDF), Private Duty Nursing Requirements Checklist (PDF), Nusing Facility Credentialing Frequently Asked Questions (PDF), Acute Care and Hospitals Quick Reference Guide (PDF), Case Management for Children and Pregnant Women (CPW) Quick Reference Guide (PDF), Centers for Medicare & Medicaid Services Website Resources (PDF), Direct Payment Program Frequently Asked Questions (PDF), FQHC Payment Process Quick Reference Guide (PDF), HEDIS Guidelines for Monitoring for Patients on PersistentMedications (PDF), Ophthalmology Quick Reference Guide (PDF), Rural Health Clinic (RHC) Billing Guidelines - Quick Reference Guide (PDF), STAR+PLUS Long-Term Services (LTSS) and Supports Rate Guide (PDF), STAR+PLUS LTSS Quick Reference Guide (PDF), STAR+PLUS MMP Quick Reference Guide (PDF), Superior Pharmacy Quick Reference Guide (PDF), Wellcare By Allwell Quick Reference Guide (PDF), Wellcare vs. Wellcare By Allwell Guide (PDF), Early Childhood Intervention - Individualized Family Service Plan Information (PDF), Therapy Fee Schedule for Comprehensive Outpatient Rehabilitation Facility (Effective 9/1/17) (PDF), Therapy Fee Schedule for Home Health (Effective 9/1/17) (PDF), Therapy Fee Schedule for Individual Therapist Group (Effective 9/1/17) (PDF), Therapy Prior Authorization Requests: Clinical Documentation Criteria Quick Reference Guide (PDF), HHS Provider Notice: Texas Health Steps Document Improvement (PDF), HHS Texas Health Steps Information Flyer (PDF), Texas Health Steps Clinical Record Review Tool (PDF), Texas Health Steps Clinical Record Review Tool and Instructions, Texas Health Steps Medical Checkup Components and Provider Reference Guide (PDF), Texas Health Steps Online Provider Education, Texas Health Steps Regional Provider Relations Representatives Contact List, Texas Health Steps Quick Reference Guide (PDF), Guidelines on After Hours Telephone Accessibility (PDF), National Kidney Foundation - Chronic Kidney Disease (CKD) Risk Assessment Tool (PDF), HHS Early Childhood Intervention Services, HHS Policy Clarification:Span of Coverage (PDF), Prenatal Screening for Domestic Violence and Substance Use, Submit Attestations Online for Chronically Ill Members, Texas Health and Human Services Provider Fraud Notice (PDF), The Attorney General of Texas Initiative Combatting Sexual Exploitation (Human Trafficking), For the most recent EVV updates, please visit. You will need Adobe Reader to open PDFs on this site. Ambetter from Meridian is underwritten by Meridian Health Plan of Michigan, Inc. Additional Features to Streamline Office Operations, Secure messaging between provider & Ambetter from Meridian. Review clinical and payment policy information. Texas residents interested in learning more about Ambetter from Superior HealthPlan or enrolling in a health plan during the open enrollment period may visit https://ambetter.superiorhealthplan.com/. Provider Reminders: Claims Definitions. All rights reserved. Find your health info and healthnumbers. Discover all the ways you can manage your coverage. App Store is a service mark of Apple Inc. Google Playis atrademarkof GoogleLLC. For more complex questions or concerns, please use the NEW contact us form located on our public website, and you will receive a follow-up message within 48 hours. Additional Features to Streamline Office Operations: Protected, Convenient Access at Your Fingertips. To use a general fee schedule, Medicaid providers can click Static Fee Schedules. Your Ambetter online member account puts you in control of your health plan. *Statistical claims and the #1 Marketplace Insurance statement are in reference to national on-exchange marketplace membership and based on national Ambetter data in conjunction withfindings from 2019 Issuer Level Enrollment Data from CMS,2019 State-Level Public Use File from CMS,2019 Covered California ActiveMember Profile data,state insurance regulatory filings, and public financial filings. The app lets you access all the benefits of your Member Portal anytime, anywhere. Always on the go? Use your ZIP Code to find your personal plan. You can also request any materials on this website in another format, such as large print, braille, CD or in another language. Superior HealthPlan operates atoll-free nurse hotlinethat providers and members can call 24-hours-a-day, 7 days a week. Ambetter Health has your back every step of the way on your personal health and wellness journey. When you partner with us, you benefit from years of valuable healthcare industry experience and knowledge. We're dedicated to helping your practice run as . Use your ZIP Code to find your personal plan. Plus, its no cost for members. Please visit the PRIOR AUTHORIZATION RESOURCES dropdown on Superior's Prior Authorization webpage. Next year, Ambetter from Superior HealthPlan will be offered to Texas residents in seven additional counties, making the program available in 145 counties in the state through the Health Insurance Marketplace. Get medical help from doctors via video and phone. 11/15/21. Copyright 2022 Aetna Better Health of Texas. **Restrictions apply. Join Ambetter show Join Ambetter menu That way, you can focus on your patients. One concise view allows primary care providers to scan patient lists for Ambetter from Meridian member eligibility, care gaps, and much more.