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Neighborhood Health Plan of Rhode Island
  • Current Members
    • Choose Your Plan
    • Your Health
    • Your Rights & Privacy
    • Your Member News
  • Providers
    • Welcome
    • CVS and Optum Transitions
    • News and Updates
    • Eligibility and Claims Information
    • Become a Network Provider
    • Provider Training
    • Resources & FAQs
    • Compliance
    • Provider Manual & Newsletter
    • Clinical Resources
    • 2019 Pharmacy Resources
    • INTEGRITY Provider Appeal Rights
  • Medicare-Medicaid
    • Neighborhood INTEGRITY
    • Office for Civil Rights Notice
    • How to Join
    • Find a Provider or Pharmacy
    • Member Materials
    • Benefits
    • Prior Authorization
    • Out-of-Network Coverage
    • Health Programs
    • Pharmacy Benefits
    • Rights and Responsibilities
    • Disenrollment from Neighborhood INTEGRITY
    • Fraud, Waste and Abuse
    • Grievances and Appeals
    • For Providers
    • Contact Us
  • Become a Member
    • Become a Member
    • Find a Doctor
    • Check Your Meds
Providers  Provider Manual & Newsletter
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Provider Manual & Newsletter

Provider Manual

Provider Manual 

For more information about Neighborhood INTEGRITY (Medicare-Medicaid Plan), click here.

Provider Manual Forms

Member Services

  • Interpreter Request Form
  • Member Education Request Form
  • Member Site Change Request Form

Provider Network Management

  • New Practitioner Education Form
  • On-Call Provider Group Notification Form
  • Practitioner Termination Notification Form
  • Changes to Billing Address/Tax Identification Number Notification Form
  • Electronic Payment and Remittance Advice Application

Behavioral Health

Primary Care Provider Behavioral Health Communications Form

Claim Forms

  • Claim Form Finder - Please use this table to help determine which form to use. Updated 11/29/17
  • Adjustment Request Form [Online Form] - Updated 9/13/18
  • Claims Reconsideration Request Form - Updated 4/8/19
  • Corrected (Replacement)/Voided Claim Request Form - Updated 5/10/19
  • Provider Appeal Request Form - Updated 5/10/19
  • Claim Adjustment Grid Process - Updated 4/18/18
  • Claim Adjustment Grid - Updated 2/20/18

Medical Management

Request Forms

Pharmacy

Prior Authorization Forms

Provider Newsletter

Neighborhood News is our quarterly newsletter for providers published online. 

 

  • Welcome
  • CVS and Optum Transitions
  • News and Updates
  • Eligibility and Claims Information
  • Become a Network Provider
  • Provider Training
    • MMP TRAINING ATTESTATION
    • ADA Survey
  • Resources & FAQs
  • Compliance
  • Provider Manual & Newsletter
    • Neighborhood News
  • Clinical Resources
  • 2019 Pharmacy Resources
  • INTEGRITY Provider Appeal Rights
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Smithfield, RI 02917
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