Superior HealthPlan SHP 20174169 2019-2025 free printable template
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NetworkDevelopment SuperiorHealthPlan.com Recredentialing Applications Email Credentialing SuperiorHealthPlan.com Fax 1-866-702-4831 Mail Superior HealthPlan s Credentialing Department 5900 E. Ben White Blvd. Non accredited facilities only Return by mail to Superior HealthPlan s Contract Management 7990 Interstate 10 West Suite 300 San Antonio TX 78230 SHP. Austin TX 78741 Please Note A separate Behavioral Health Facility/Ancillary Credentialing Application must be completed for each facility...
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01
Obtain the Superior HealthPlan SHP 20174169 form from the official website or customer service.
02
Fill in your personal information, including your name, address, and date of birth.
03
Provide your insurance information, including policy number and group number.
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Complete the sections detailing your medical history and any current medications.
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Sign and date the form to confirm the information is accurate.
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Submit the completed form to Superior HealthPlan either online, via email, or by mail as directed.
Who needs Superior HealthPlan SHP 20174169?
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Individuals seeking health coverage under the Medicaid program in Texas.
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Families with low income who require accessible medical services.
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Children needing medical support who qualify based on state guidelines.
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Individuals with specific health needs that align with the plan's offerings.
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What is Superior HealthPlan SHP 20174169?
Superior HealthPlan SHP 20174169 is a specific form or document related to the health insurance services provided by Superior HealthPlan, used for administrative and reporting purposes.
Who is required to file Superior HealthPlan SHP 20174169?
Providers and healthcare organizations that participate in the Superior HealthPlan network and need to report specific healthcare services or claims are required to file Superior HealthPlan SHP 20174169.
How to fill out Superior HealthPlan SHP 20174169?
To fill out Superior HealthPlan SHP 20174169, gather all necessary patient and service information, complete each section clearly and accurately, ensuring all required fields are filled in accordance with the guidelines provided by Superior HealthPlan.
What is the purpose of Superior HealthPlan SHP 20174169?
The purpose of Superior HealthPlan SHP 20174169 is to facilitate the reporting and processing of healthcare services, ensuring accurate claims and communication between providers and the health plan.
What information must be reported on Superior HealthPlan SHP 20174169?
The information that must be reported on Superior HealthPlan SHP 20174169 includes patient identification details, treatment dates, service codes, provider information, and any other relevant data as required by Superior HealthPlan guidelines.
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