Providers

Important Updates

INTEGRITY for Duals and Dual CONNECT Now Live

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.

Behavioral Health Services Now Managed In-House at Neighborhood
Behavioral Health – Effective for dates of service on or after September 1, 2025, Neighborhood Health Plan of Rhode Island (Neighborhood) is now directly managing all behavioral health services for its members in all lines of business. Optum, the previous behavioral health vendor, will continue supporting behavioral health services for all dates of service through August 31, 2025. For more information and FAQs, please click here.

Important Reminders

Provider Screening Requirement
Make sure you complete and maintain Rhode Island Medicaid screening as mandated by the 21st Century Cures Act. It is the provider’s responsibility to ensure their individual and group NPI screening status does not expire, which could impact payment and/or participation status with Neighborhood. For instructions on how to maintain compliance, please refer to our screening and enrollment guidelines.

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