Superior HealthPlan Timely Filing Limit: 95 Days Made Easy

The Superior HealthPlan timely filing limit is 95 days from the date of service, and it leaves almost no room for slow billing. Superior is one of the largest Texas Medicaid managed care plans, so for many Texas practices a big share of Medicaid revenue runs through this one deadline. A claim that sits in a rejection queue, waits on an unclear eligibility check or goes to the wrong payer first can lose the whole 95 days. On the Texas claims we work, most late Superior claims were billed on time and then rejected, and nobody fixed them before day 95.

This guide covers every Superior deadline: first claims, rejected claims, corrected claims, appeals, Ambetter from Superior and dual-eligible members.

Superior HealthPlan Timely Filing Limit at a Glance

Superior’s own quick reference guides (QRGs) and billing clinic materials set the Superior HealthPlan timely filing limit for each claim type. The key word is received: Superior must have the claim by the deadline, not just your clearinghouse.

Which Superior Plans Does This Cover?

Superior HealthPlan, a Centene company, runs several Texas programs, and not all of them share one deadline. The 95-day Superior HealthPlan timely filing limit applies to its Medicaid and CHIP products:

• STAR (Medicaid for children, pregnant women and families)
• STAR+PLUS (adults with disabilities and adults 65+)
• STAR Kids (children and young adults with disabilities)
• STAR Health (children in foster care)
• CHIP

Ambetter from Superior HealthPlan is a Marketplace (ACA) plan, not Medicaid. Its quick reference guide also lists 95 days from the date of service. Superior’s Medicare products, such as Wellcare By Allwell and the STAR+PLUS Medicare-Medicaid Plan (MMP), may follow different rules. [VERIFY: Superior Medicare Advantage and MMP filing limits — Superior’s own Medicare QRG] Check the member’s ID card before you pick a deadline.

Superior HealthPlan payer IDs

Superior’s PCP QRG lists payer ID 68069 for medical claims and 68068 for behavioral health EDI claims. The Behavioral Health QRG (updated June 2024) lists 68068 for Medicaid/CHIP behavioral health claims through Availity and 68069 for Ambetter, Wellcare By Allwell and STAR+PLUS MMP. Confirm the right ID for your provider type with your clearinghouse.

How to Count the Superior HealthPlan Timely Filing Limit (Worked Example)

Count the date of service as day 0. Under the Superior HealthPlan timely filing limit, day 95 is the last day Superior can receive the claim. Here’s a real-date example.

What went wrong: The rejection on day 77 left 18 days to fix the claim. It sat in the queue for 22 days. If the team had worked it within 48 hours, the claim would have been received around day 79, with 16 days to spare.

The 120-day example: The Superior HealthPlan timely filing limit for corrections works differently. A different claim for the same patient was paid, but underpaid. The EOP is dated June 1, 2026. Day 120 from the EOP is September 29, 2026. A corrected claim or reconsideration must reach Superior by then.

Superior HealthPlan Timely Filing Limit for Corrected Claims and Appeals

Once Superior processes a claim, the Superior HealthPlan timely filing limit for fixes is different: you have 120 days from the EOP date to correct it, ask for a reconsideration or file a dispute, per the PCP QRG. Claim appeals must reach Superior within 120 days from the date the claim was finalized, per the Behavioral Health QRG.

How to send a corrected claim to Superior

• Electronically: through your clearinghouse (EDI) or Superior’s Secure Provider Portal. Use the correct claim frequency code and the original claim number from the EOP.
• On paper: use a standard red-and-white UB-04 or CMS-1500 (Superior doesn’t accept handwritten corrected claims). Put the original claim number in field 64 (UB-04) or field 22 (CMS-1500), attach the original EOP, and mail to Superior HealthPlan, P.O. Box 3003, Farmington, MO 63640-3803.

Reconsideration vs dispute vs appeal

Superior uses these terms for different steps. A corrected claim fixes your own error. A reconsideration asks Superior to review its payment. A dispute or appeal challenges the result after review. [VERIFY: exact definitions and order of steps in the current Superior Provider Manual] Paper claim appeals go to Superior HealthPlan, P.O. Box 3000, Farmington, MO 63640-3800 (PCP QRG).

How to Prove You Met the Superior HealthPlan Timely Filing Limit

If Superior denies a claim under the Superior HealthPlan timely filing limit and you believe it was on time, proof is everything. Superior’s billing clinic accepts:

• Centene EDI acceptance reports showing Superior accepted the claim. Your clearinghouse’s own acceptance alone is not enough; it must show Superior received it.
• Certified or overnight mail receipts for paper claims.

Save your 999 and 277CA reports for every batch, named by date. When a timely filing denial comes back months later, those files are the difference between a write-off and a paid claim.

How to Never Miss a Superior Deadline: 7 Steps

1. Check Medicaid eligibility and the MCO at every visit. The Superior HealthPlan timely filing limit only helps if Superior is the right payer. Use TMHP eligibility tools to confirm the member is with Superior, not another plan, on that date of service.
2. Bill within 7–14 days of the date of service. Fast billing leaves most of the Superior HealthPlan timely filing limit free for fixing problems.
3. Work rejections within 48 hours. A rejection doesn’t stop the Superior HealthPlan timely filing limit, so treat it as urgent.
4. Track “days since DOS” on every open Superior claim and sort by it weekly.
5. Set alerts at 60, 75 and 85 days. For a February 2, 2026 visit, that’s April 3, April 18 and April 28, 2026.
6. Save acceptance reports. Keep the Centene EDI acceptance report, 999 and 277CA for every claim.
7. Send corrections and appeals early. Don’t wait until day 110 of the 120. Mail and portal delays count against you.

Common Mistakes and Denials (and How to Fix Them)

These are the mistakes that most often break the Superior HealthPlan timely filing limit and turn a claim into a write-off. The codes are the standard ones payers use; check your Superior EOP for the exact codes. [VERIFY: exact CARC/RARC codes on Superior EOPs] For a wider prevention plan, see how to reduce claim denials.

Behavioral Health Providers and Superior

Behavioral health claims follow the same Superior HealthPlan timely filing limit of 95 days, but they have their own addresses, payer ID and authorization rules. Superior’s Behavioral Health QRG (updated June 2024) lists:

• Paper BH claims: Superior HealthPlan, Behavioral Health Claims, P.O. Box 6300, Farmington, MO 63640-6806
• Paper BH appeals: Superior HealthPlan, Attn: Behavioral Health Appeals, P.O. Box 6000, Farmington, MO 63640-3809
• Prior authorization is required for services such as inpatient admissions, residential treatment, ECT, and outpatient facility services like PHP, IOP and day treatment.

Missing authorization is a separate denial from timely filing, but it often causes the delay that pushes a claim past day 95. If you bill Texas Medicaid behavioral health services, see our guides to behavioral health H codes and IOP billing.

Superior HealthPlan Timely Filing Limit vs Texas Medicaid, BCBS Texas and Medicare

The Superior HealthPlan timely filing limit matches Texas Medicaid fee-for-service, but it’s far shorter than Medicare. Don’t use one payer’s deadline for another.

If your Texas practice juggles several of these payers, our Austin medical billing team tracks each deadline by payer.

FAQs

What is the timely filing limit for Superior HealthPlan?

The Superior HealthPlan timely filing limit is 95 days from the date of service for first claims on STAR, STAR+PLUS, STAR Kids, STAR Health and CHIP members. Superior must receive the claim by day 95. A claim that was rejected and not fixed in time is treated as late.

How long do I have to submit a corrected claim to Superior?

Superior’s PCP quick reference guide gives 120 days from the date of the Explanation of Payment (EOP) for corrected claims, reconsiderations and claim disputes. Include the original claim number and the correct frequency code, or attach the original EOP on a paper corrected claim.

What is the Superior HealthPlan appeal deadline?

Superior’s Behavioral Health QRG says claim appeals must be received within 120 days from the date the claim was finalized. Paper medical appeals go to P.O. Box 3000, Farmington, MO 63640-3800, and behavioral health appeals to P.O. Box 6000, Farmington, MO 63640-3809.

Does a rejected claim count as filed with Superior?

No. Superior’s billing clinic states that rejected claims must be corrected and resubmitted within 95 days of the date of service. A rejection means the claim never entered Superior’s system, so the 95-day clock keeps running until a clean claim is received.

How do I prove timely filing to Superior HealthPlan?

Superior accepts a Centene EDI acceptance report showing it received the claim, or a certified or overnight mail receipt for paper claims. A clearinghouse report that only shows your clearinghouse accepted the claim is not enough. Keep these reports for every batch.

Do I bill Superior for dual-eligible members?

No. For members with both Medicare and Medicaid, Superior’s billing clinic says providers don’t bill Superior, so the Superior HealthPlan timely filing limit doesn’t apply to the crossover. Bill Medicare first; the Medicaid crossover goes through TMHP. Sending these claims to Superior wastes time that counts against your deadlines.

Is Ambetter from Superior the same timely filing limit?

Ambetter from Superior HealthPlan, the Texas Marketplace plan, uses the same Superior HealthPlan timely filing limit of 95 days from the date of service, per its provider quick reference guide. It is a separate product with its own claims address and payer ID, so check the member’s ID card before you bill.

Protect Every Claim From Superior’s 95-Day Clock

The Superior HealthPlan timely filing limit gives you 95 days, and rejections, eligibility mix-ups and dual-eligible errors eat into that time fast. Bill within two weeks, fix rejections within 48 hours, keep your acceptance reports, and send corrections well before day 120. If Superior claims keep slipping past the deadline, our denial management services track every claim by payer and fix problems before time runs out. Book a free billing review.

This article is for education only. Filing rules change. Confirm current deadlines in Superior HealthPlan’s provider manual and quick reference guides before you bill.

Sources

• Superior HealthPlan: Primary Care Provider Quick Reference Guide (SHP_202612824D)
• Superior HealthPlan: Behavioral Health Quick Reference Guide (SHP_20239698)
• Superior HealthPlan: Corrected Claim Form instructions
• Superior HealthPlan: Behavioral Health Billing Clinic, STAR, STAR Health, STAR Kids and STAR+PLUS (SHP_20229153A)
• Ambetter from Superior HealthPlan: Provider Quick Reference Guide
• TMHP: Texas Medicaid Provider Procedures Manual, Vol. 1, Section 6

Last updated: October 2026.