How To Submit Claims To Superior HealthPlan

For Superior HealthPlan, the practical claims workflow usually starts with electronic submission guidance and only falls back to paper instructions when the payer documents a mailing address for specific claim types or exceptions. The details below keep the workflow broad instead of reducing it to a single address.

At a glance

• Superior allows electronic claim submission through the Secure Provider Portal or via clearinghouse EDI, and also accepts paper CMS-1500 and UB-04/CMS-1450 forms. The portal supports claims submission, claim status, eligibility verification, and authorization functions. Paper claim mailing addresses vary by product; the general claims mailing address on the billing/coding page is Superior HealthPlan, P.O. Box 3003, Farmington, MO 63640-3803. Out-of-network providers must submit one electronic or paper claim first to be set up in the secure portal. Corrected claims may be submitted electronically, through the portal, or by mail, and must include the original claim number and proper resubmission codes.

Submission channels

• Secure Provider Portal
• EDI / clearinghouse
• Paper CMS-1500
• Paper UB-04 / CMS-1450
• Mail

Electronic claims payer IDs

• Not clearly published in the researched sources.

Paper claims addresses

• Superior HealthPlan, P.O. Box 3003, Farmington, MO 63640-3803
• Ambetter from Superior HealthPlan, P.O. Box 5010, Farmington, MO 63640-5010

Corrected claims and follow-up

• Use the Corrected Claim form when mailing paper corrected claims.

• Do not use handwritten or stamped verbiage on corrected claims.

• Paper corrected claims must be on standard red-and-white UB-04 or HCFA 1500 forms.

• Include the original claim number in field 64 of UB-04 or field 22 of HCFA 1500.

• Include the appropriate frequency/resubmission code in field 4 of UB-04 and field 22 of HCFA 1500.

• Corrected claims may be submitted via EDI, the Secure Provider Portal, or by mail.

• Claims status resource 1

• Claims status resource 2

Caveats

• Submission options and paper addresses can vary by product line.
• The available evidence did not provide a universal payer ID for all Superior products.
• Some services may require specialized portals or delegates rather than the main portal.

Provider resources

• Provider login / secure portal (official)
• Prior authorization overview and fax/phone/portal directory (official)
• Billing and coding / electronic transactions (official)
• Provider forms (official)
• Medicaid provider manual PDF (official)
• STAR+PLUS MMP provider manual PDF (official)
• Corrected claim form (official)

Sources