Providers

Providers may experience extended processing times for INTEGRITY for Duals and Dual CONNECT claims as a result of the product transition. Please note all claims will be adjudicated within applicable contractual timeframes. Thank you for your patience as we ensure a successful transition.

Neighborhood Health Plan of Rhode Island is informing providers of a temporary issue affecting machine-readable ASCX12 835 remittance advice (RA) files for Neighborhood INTEGRITY for Duals (HMO DSNP) and Dual CONNECT (HMO D-SNP) claims.

Due to an issue, 835 files for D-SNP claims will not be generated. Work is underway to resolve the issue, which is expected to take up to eight weeks.

Providers who currently receive only an 835 file can complete the Electronic Payment and Remittance Advice Application to receive electronic or paper remittance advices. Completed forms should be emailed to eftproviders@nhpri.org.

We will share updates as more definitive information becomes available. Thank you for your patience and understanding as we work to resolve this issue. Read more here. 

Neighborhood Health Plan of Rhode Island has introduced two new product offerings, beginning January 1, 2026: Neighborhood INTEGRITY for Duals (HMO D-SNP) and Neighborhood Dual CONNECT (HMO D-SNP). 

The D-SNP Provider Page is designed to help providers access key information and tools related to Neighborhood’s Dual Eligible Special Needs Plans (D-SNPs). Here you’ll find helpful resources, including a detailed FAQ section, to answer common questions and support you in meeting plan requirements. We’ll continue to update this page with new guidance and materials, so check back regularly to stay informed and equipped to deliver the best care to our members.

These new plans are being introduced as the former Medicare-Medicaid Plan (MMP), Neighborhood INTEGRITY, has been sunset as of December 31, 2025, as required by the Centers for Medicare and Medicaid Services (CMS). Please click here for more information about this transition.

Important Changes for Providers

1. Payer ID Alignment: The payer ID for these products will be 05047, meaning all Neighborhood lines of business will now share the same payer ID as of January 1, 2026. For dates of service through December 31, 2025, please continue billing Neighborhood INTEGRITY (MMP) members using the INTEGRITY (MMP) Claims Payer ID is 96240.

2. New Member ID Cards: All D-SNP members (both Neighborhood Dual CONNECT and Neighborhood INTEGRITY for Duals) will be issued new member ID cards with ID numbers that:

a. Are 12 digits in length
b. Start with “12” as an identifying prefix

For dates of service prior to January 1, 2026, please use the member’s INTEGRITY (MMP) ID number which start with a “130” number. For dates of service after January 1, 2026, please use the member’s new INTEGRITY for Duals or Dual CONNECT ID number which start with a “12” number.