All Rights Reserved. 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. You will need Adobe Reader to open PDFs on this site. Use Ambetter's tool to help you find an in-network doctor, specialist, or health care facility such as a hospital, urgent care clinic, or pharmacy. There, you can find information about your Ambetter coverage, access options for care and much more all in one place. Make your first payment to access great benefits. Check Now Provider Resources If you dont want to leave our site, choose the X in the upper right corner to close this message. This plan includes access to licensed virtual primary care providers in addition to Ambetters core network of health care providers and hospitals. 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 - EVV Roles and Responsibilities (Part 1) (PDF), HHS EVV Tool Kit Module 3 - EVV Roles and Responsibilities (Part 2) (PDF), HHS EVV Tool Kit Module 4 - EVV Visit Transactions (PDF), HHS EVV Tool Kit Module 5 - EVV Visit Maintenance (PDF), HHS EVV Tool Kit Module 6 - EVV Process Flow (PDF), HHS EVV Tool Kit Module 7 - EVV Aggregator and Portal (PDF), HHS EVV Tool Kit Module 8 - Submitting an EVV Claim (PDF), HHS EVV Tool Kit Module 9 - EVV Portal Standard Reports and Search Tools (PDF), HHS EVV Tool Kit Module 10 - EVV Visit Transaction Validation Enhancements (PDF), HHS EVV Tool Kit Module 11 - Summary of EVV Changes (Part 1) (PDF), HHS EVV Tool Kit Module 12 - Getting Started - Next Steps (PDF), HHS EVV Tool Kit Module 13 - EVV Training Requirements (PDF), HHS EVV Roadshow Instructor-lead Training Schedule, Summer-Fall (PDF), HHS EVV Tool Kit Module 14 - EVV Compliance Oversight Policies (PDF), HHS EVV Tool Kit Module 15 - Best Practices to Avoid EVV Claim Mismatches (PDF), TMHP Electronic Visit Verification (EVV) FAQ (PDF), Visit Maintenance Unlock Request for Program Provider and FMSA (Excel), Visit Maintenance Unlock Request for Consumer Directed Services Employers (Excel), Drugs of Abuse and Genetic/Molecular Diagnostic Testing Prior Authorization Notice (PDF), Drugs of Abuse Prior Authorization Code List (PDF), Preferred DME Supplier (Medline) FAQ (PDF), Preferred DME Supplier (Medline) Supplies Available without Prior Authorization List (PDF), Prior Authorization List - 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. Your area isn't covered? *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 with findings from 2021 Rate Review data from CMS, 2021 State-Level Public Use File from CMS, state insurance regulatory filings, and public financial filings. Your Texas Benefitsprovidesthe info on the next page. You can also ask for info on health conditions and wellness topics in print. If you dont yet have a member account, visit Member.AmbetterHealth.comto set one up today. Give us a call if you have any questions as you shop and explore . Find and enroll in a plan that's right for you. Visibility of Multiple TINs. A provider has thirty (30) calendar days from the date of the incident, such as the original Explanation of Payment date, to file a complaint/grievance. Find and enroll in a plan that's right for you. The Ambetter from Peach State Health Plan login portal is where you manage your account. Receiving calls and/or text messages from Aetna Better Health of Texas that are informational and relate to my health and benefits. Copyright 2023 Centene Corporation. Join Ambetter show Join Ambetter menu Then, you can: See your member ID card or ask for a new one Change your primary care physician (PCP) Update your contact info Find forms and materials See your health history Track your health goals Stay up to date with the latest news and announcements. Questions? Find and enroll in a plan that's right for you. Or use your Aetna Better Healthapp to take your benefits on the go. Use the tabs or the previous and next buttons to change the displayed slide. Find and enroll in a plan that's right for you. A carousel is a rotating set of images, rotation stops on keyboard focus on carousel tab controls or hovering the mouse pointer over images. View patient demographics & history. Print or download it to your smart phone so you always have it with you. You will need Adobe Reader to open PDFs on this site. You can get answers to medical questions and care advice even prescriptions. Because protecting peoples health is why were here, and its what well always do. Aetna Better Health provides the general info on the next page. Copyright 2023 Celtic Insurance Company. $0 Ambetter Telehealth cost share does not apply to HSA plans until the deductible is met. Find everything you need in the member online account, Select your state to visit the Ambetter site for your coverage area. See coverage in your area; Find doctors and hospitals; View pharmacy program benefits; View essential health benefits; Find and enroll in a plan that's right for you. With Ambetter, you can rely on the services and support that you need to deliver the best quality of patient care. The fee displayed is the allowable rate for this service. What is Ambetter from Arizona Complete Health? What you need to know about the Coronavirus. 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/. Copyright 2023 Celtic Insurance Company. Use our helpful resources to deliver the best quality of care. Aetnaprovides infoabout COVID-19on the next page. Submit and manage claims, including batch files, for free. Youre dedicated to your patients, so were dedicated to you. For Ambetter from Superior HealthPlan provider resources, please visit Ambetter from Superior HealthPlan - Provider Resources. Ready to learn more? 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. Ambetter. Download the free version of Adobe Reader. Or choose Go on tomove forward to Aetna.com. Shop and Compare Plans Find a Doctor Shop and Compare Plans Use your ZIP Code to find your personal plan. Copyright 2023 Meridian Health Plan of Michigan, Inc. All rights reserved. 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. Use your member account anytime to conveniently do things like: If you dont yet have a member account, visit Member.AmbetterHealth.com to set one up today. Billing Resources Electronic Visit Verification (EVV) Use your ZIP Code to find your personal plan. What is Ambetter? Youre dedicated to your patients, so were dedicated to you. Our resources for Texas providers within the Superior network includes the tools and support you need to deliver the best quality of care. Yes. That way, you can focus on your patients. Your Ambetter coverage includes no-cost in-network Telehealth services. Have your tax ID number ready during sign up. If you dont want to leave the member site, choose the X in the upper right corner to close this message. Date: Register your account today! Use your ZIP Code to find your personal plan. If you dont want to leave our site, choose the X in the upper right corner to close this message. Were dedicated to helping your practice run as efficiently as possible, which is why we always strive for prompt claims processing. Theyve always been able to count on you. At the end of the day, our job is to make yours easier. When you partner with us, you benefit from years of valuable healthcare industry experience and knowledge. You can call 1-855-231-3716to ask for a printed copy of the health survey. Find and enroll in a plan that's right for you. Quality Improvement resources have moved.
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