SHP Depts
This team focuses on provider relationships, development of contracts, and long-term planning for the network.
Who is Network Development? (Net Dev)
This program is designed for individuals who qualify for Medicaid, and are under 65 years of age.
What is STAR?
What is also known as the Healthcare Common Procedure Coding System?
What is HCPCS?
This position identifies the Frequency of the Bill.
What is the 3rd Position?
This screen is also called the Claims By Authorization screen.
What is IQ1100?
This team verifies and assesses the qualifications and background of licenses professionals.
Who is Credentialing?
This program is designed for Children in TX without health insurance whose families earn too much to qualify for Medicaid.
What is CHIP?
What is also known as the Current Procedural Terminology?
What is CPT?
This position identifies the Type of Facility.
What is the 1st Position?
This screen is used for Procedure Inquiries.
What is IQ0400?
Which team is the contact center to assist our providers?
Who are Provider services?
This program provides Medicaid benefits to most children and youth in the TX Dept of Family and Protective Services conservatorship.
What is STAR Health?
What category are CPT codes ranging from 10021-69990?
What is Surgery?
The first position of the bill type would be a number 1 for this type of facility.
What is Hospital?
This screen is used to determine if a provider is on review.
What is PR0220?
This team handles requests from providers to complete medical necessity review prior to rendering services.
Who is Utilization Management (UM)?
This program serves youth and children who receive disability related Medicaid.
What is STAR Kids?
What CPT Code ranges from 70010-79999?
What are Radiology codes?
The second digit of the bill type on a UB-04 would be a 3 for this bill classification.
What is 3?
This screen is used to see all claims submitted for a particular member number.
What is IQ1300?
Which team ensures our providers are well-informed, up to date with processes, and verifies provider's overall satisfaction with SHP?
Who is Account Management?
This program is Superior's commercial solution which was provisioned as part of the Affordable Care Act.
What is Ambetter?
This is a 2-character code that indicates a service/proc has been altered by specific circumstance.
What is a Modifier?
This UB-04 Bill type would mean Hospital, Outpatient, Admit through discharge.
What is 131?
What is IQ0880?