Recent News for Neighborhood Providers
2023
Neighborhood Postpones Transition of Claim Processing for Commercial Line of Business Neighborhood Reminders (September 1, 2023)Important Updates to Claim Processing for Neighborhood’s Commercial Line of Business (August 1, 2023)Radiology Services Appeal Process Change (August 1, 2023)New SNF and Rehab Authorization Request E-Form Now Available (August 1, 2023)Update: Form CMS-1500 Requirements for Neighborhood (July 6, 2023) – Originally appeared in July 2023 Provider Newsletter Delay in Home Care Gap Notification Form Implementation (June 16, 2023)Notice of Change to G-CSF First Treatment Strategy (June 1, 2023)Notice of Electronic Claim Submission Requirement (June 1, 2023)Pharmacy Webpage Restructuring (May 15, 2023)Improved Process for Home Care Gap Notification Form (May 15, 2023)Home Care Gap Notification (April 28, 2023)New Prescribing Requirement for GLP-1 Medications (March 1, 2023)Provider Guidance for Medicaid Members (Adult-Only) Requiring Long-Term Non-Skilled Services (March 1, 2023)ADA Compliance Reminder – Members Requiring a Stretcher or Wheelchair (March 1, 2023)Form CMS-1500 Requirements for Neighborhood – Clarification (February 20, 2023)Guidance for NDC Requirement on Medicaid Medical Benefit Claims (February 1, 2023)Improved Process for PCP Change Requests (February 1, 2023)Meal Delivery Benefit for Neighborhood Commercial New Moms (February 1, 2023)
2022
Neighborhood is Removing Select Prior Authorization Requirements in 2023 (December 1, 2022)Neighborhood Crossing Enhancements in 2023 (November 1, 2022)Rhode Island Expands Monkeypox Vaccination Efforts (August 4, 2022)New and Improved Process for Requesting Interpreter Services (May 31, 2022)New Telemedicine/Telephone Services Payment Policy, Effective July 1, 2022 (May 1, 2022)Improved Process for Claim Reconsideration Requests – eForm Required June 1, 2022 (April 1, 2022)Revised Speech Therapy Services Payment Policy – Effective May 1, 2022 (February 24, 2022)Revised Physical and Occupational Rehabilitation Services Payment Policy – Effective April 1, 2022 (February 1, 2022)Acupuncture Services Payment Policy for Neighborhood Commercial Members (February 1, 2022)Reinstatement of Temporary Telemedicine/Telephone-Only Payment Policies (January 28, 2022)
2021
Effective March 1, 2022 – Revised Vision Care Services Payment Policy (December 31, 3021)Reminder: Updated Timeframes for Claim Submission and Review Processing (December 30, 2021)DME Device Voluntary Recall Alert (November 30, 2021)Updated Timeframes for Claim Submission and Review Processing (November 9, 2021)Delayed Provider Payment for Medicaid (November 4, 2021)Improved Process for Requesting Adjustments to Multiple Claims (October 1, 2021)Provider Notification – Professional and Facility Industry Standard Coding Requirements Regarding Bundled Billing (September 1, 2021)Provider News – Claims Submission Requirement Reminder for Institutional Claims (July 26, 2021)Provider News – DME Network Change (June 28, 2021)Provider Notification – Annual Provider Training Requirement (June 21, 2021)Provider Notification – Notice of Change in Remittance Advice Distribution (June 15, 2021)Provider Notification – Neighborhood Clinical Medical Policy Procedure Reminder (June 8, 2021)Provider Notification – Updated Neighborhood Health Plan of Rhode Island Payment Policies and New Archive Webpage (June 1, 2021)Provider Notification – Revised Payment Policies for Physical and Occupational Rehabilitation Services and Speech Therapy Services (April 30, 2021)Provider Notification – Update Your Information and Email Registration (April 2, 2021)Potential Delayed Provider Payments for Medicaid (January 8, 2021)Effective January 1, 2021 – Updated Payment Policy for Hospital Readmissions (January 7, 2021)
2018-2020
Effective January 1, 2021 – Updated Payment Policies for Outpatient Physical and Occupational Therapy and Speech Therapy Services (Medicaid Only) (December 11, 2020)Effective November 2, 2020 – Updated Payment Policy for Multiple Procedures (November 2, 2020)Effective January 1, 2021 – Updated Payment Policy for Outpatient Physical and Occupational Therapy (November 1, 2020)Effective January 1, 2021 – Updated Payment Policy for Speech Therapy Services (*November 1, 2020)New Payment Policy for Outpatient Physical and Occupational Rehabilitation Services (September 18, 2020)New Payment Policy for Multiple Procedures (September 2, 2020)Update – Delayed Provider Payment for Commercial and INTEGRITY (August 24, 2020)Delayed Payment for Commercial and INTEGRITY (MMP) – Paper & Electronic (August 21, 2020)Delayed Provider Payment for Medicaid (May 22, 2020) New Payment Policy for Hospital Readmission (January 31, 2020)Revised Payment Policy for Provider Preventable Conditions (January 31, 2020)Revised Payment Policy for Pharmaceutical Supplies (January 31, 2020)Provider Appeals – Name and Process Change (January 31, 2020)Typographical Error on Remittance Advice Statements for Medicaid Pay Cycle (January 3, 2020)Delayed Provider Payment Cycle for Medicaid (November 1, 2019) Delayed Provider Payment Cycle for Medicaid September 6, 2019) Delayed Provider Payment Cycle for Medicaid (May 24, 2019) Paper Remittance Advice (RA) Documentation (January 29, 2019)Provider Payment Cycle Update (November 1, 2018) Provider Payment Cycle Update (October 19, 2018) INTEGRITY Reimbursement Logic (September 25, 2018)UNITY Product Transition Update (September 6, 2018)
CVS Caremark Transition
Optum Transition
CVS and Optum Transitoons CVS Caremark® and Optum® Transitions
To help our providers prepare for changes to management of behavioral health and pharmacy benefits effective January 1, 2019, please refer to these resources. This page will be updated with new information as it becomes available.