Centene / Superior HealthPlan
Welcome to the Superior HealthPlan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and information designed to assist you in using the RadMD Website to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Gina Braswell.
Update on COVID-19
Documents
*Updated documents providing clarification on prior authorization requirements for CCTA, Stress Echo, Echocardiography and Nuclear Cardiology procedures.
- Superior HealthPlan Quick Reference Guide for Ordering Physicians - Updated 4/2/18*
- Superior HealthPlan Quick Reference Guide for Imaging Providers - Updated 4/2/18*
- Superior Healthplan Provider FAQ
- Superior HealthPlan Medicaid RBM Utilization Review Matrix-2021
- Superior HealthPlan Medicaid Star Plus RBM Utilization Review Matrix-2021
- Superior HealthPlan Ambetter and Medicare Utilization Review Matrix-2021
- Superior HealthPlan Provider Education Presentation
- Superior HealthPlan Prior Authorization Checklist (non-cardiac)
- Superior HealthPlan Prior Authorization Request Form
- Superior HealthPlan Spine MRI and Spine CT Test Request Tip Sheet
- Superior HealthPlan Pediatric Tip Sheet
Cardiac Educational Documents
- Cardiac Solution Tip Sheet
- MPI versus Stress Echo Tip Sheet
- Superior HealthPlan Cardiology Checklist
- Superior HealthPlan Cardiology Frequently Asked Questions
- Superior HealthPlan/NIA Cardiac Intro Letter for Facilities
Physical Medicine
- Superior HealthPlan Physical Medicine FAQ
- Superior HealthPlan Physical Medicine Quick Reference Guide
- Superior HealthPlan Physical Medicine Provider Training PPT
- Superior HealthPlan Outpatient Habilitative and Rehabilitative Speech Therapy
- Superior HealthPlan Outpatient Habilitative Physical and Occupational Therapy
- Superior HealthPlan Record Keeping and Documentation Standards
- Superior HealthPlan Physical Medicine Tip Sheet & Checklist
- Superior HealthPlan Physical Medicine Recorded Provider Training
Facility Scheduling Program
- Superior HealthPlan Facility Selection and Member Scheduling Provider Announcement Letter
- Superior HealthPlan Questions and Answers Document for Facility Scheduling Program
RadMD Documents
RadMD is our user-friendly, real-time tool that provides you with instant access to the high-tech imaging authorization and supporting information you need. Whether submitting imaging exam requests or checking the status of a prior authorization request, you will find RadMD to be an efficient, easy-to-navigate resource.
Search for resources by solution below:
Interventional Pain Management (IPM)
- Superior HealthPlan Interventional Pain Management (IPM) FAQ - Effective 1/1/21
- Superior HealthPlan Interventional Pain Management (IPM) QRG - Effective 1/1/21
- Superior HealthPlan Interventional Pain Management (IPM) Provider Education Presentation - Effective 1/1/21
- Superior HealthPlan Non CHIP Interventional Pain Management Utilization Review Matrix-2021
- Superior IPM Recording of Provider Physical Medicine Training
Recorded General Trainings
We have a series of training videos that discuss the components of requesting a prior authorization request. Click here to access these videos.
Recorded RadMD Demos
Need additional help using RadMD? Click here to access a series of RadMD demos that demonstrate how to properly submit a prior authorization request.
Click the link below to see information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.
Clinical Guidelines
- Clinical Guidelines
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Refer to the Utilization Review Matrix document to view specific codes managed by NIA
Clinical Training Modules
We have a series of clinical training modules that will help you avoid delays and ensure that you have the right information before submitting your prior authorization request. Click here to access them.