Recent News for Neighborhood Providers
2025
- Reminder: LTSS Approval Required for Home Care Hours Above Preventive Level – INTEGRITY (MMP) (April 25, 2025)
- Telemedicine Policy Updates (April 25, 2025)
- New Streamlined Home Care Prior Authorization Forms Now Available (April 24, 2025)
- Neighborhood to Manage Behavioral Health Services Beginning September 1, 2025 (March 4, 2025)
- Implementation of Transportation Payment Policy (March 1, 2025)
- NaviNet’s New Feature: Patient List (February 14, 2025)
- Improved Process for Home Care Grid (February 3, 2025)
- Update to Secondary Claim Submission Timeframe (February 1, 2025)
- Health Risk Assessment Reminder (January 31, 2025)
- Update on Appeals for Post-Service Authorizations (January 14, 2025)
- Provider Questions? We Have Answers (January 14, 2025)
- Neighborhood to Expand Evolent Physical Medicine Program (January 1, 2025)
- Update to Low-Dose CT Scan Authorization Requirement (January 1, 2025)
- Update to Maternal Meal Delivery Program (January 1, 2025)
- Important Update on Billing Codes for Home Health PT/OT/ST Services & Behavioral Health State Enhancement Reimbursement Rate Changes (December 20, 2024)
- Changes to Authorization Requirements for Select Services Under Medicaid and Commercial Lines of Business (November 1, 2024)
- Prior Authorization Requirements Removed for Select Commercial Home Health Care Services (November 1, 2024)
- Changes to Acupuncture Coverage for Commercial Members (November 1, 2024)
- Reminder: Sterilization Consent Form for Medicaid Members (November 1, 2024)
- INTEGRITY (MMP) Line of Business Added to Vitamin D Testing Policy (November 1, 2024)
- Reminder: INTEGRITY (MMP) Medicare Requirements (November 1, 2024)
- Process Update: Submitting Explanation of Benefit Information (November 1, 2024)
- Changes to Provider Appeals Submission Process (October 1, 2024)
- Prior Authorization Requirements Removed for Chiropractic Services (October 1, 2024)
- Neighborhood Clearinghouse Update (September 13, 2024)
- Reminder: Use of Corrected/Voided Claim Request Form (September 1, 2024)
- New Documentation Requirements for Adult Day Services (August 28, 2024)
- New Documentation Requirements for Pediatric Home Health Services; Billing Reminder (August 28, 2024)
- Post-Service Prior Authorizations No Longer Accepted for MMP Line of Business (August 7, 2024)
- Reminder: Documentation Requirements for Pain Management Prior Authorizations (May 22, 2024)
- New Reimbursement Rate for Occupational and Physical Therapy Services (May 15, 2024)
- Home Health Care Prior Authorization Requirement to be Removed (May 9, 2024)
- Vision, Medical Prior Authorization Requirements to be Removed (May 9, 2024)
- Update to Neighborhood’s Access to Care Standards for INTEGRITY Members (May 1, 2024)
- New Documentation Requirements for Plastic Surgery Procedures (May 1, 2024)
- Neighborhood Reconnected to Change Healthcare (April 15, 2024)
- Update to Provider Appeals Submission Process (April 1, 2024)
- New Vitamin D Testing Policy for Medicaid and Commercial Members (April 1, 2024)
- Important Updates to Claim Processing for Neighborhood’s Commercial Line of Business (March 27, 2024)
- Reminder: Claims Processing Policy for Modifier 25 (March 26, 2024)
- Update: Delegation of Services to Evolent Delayed to June (March 18, 2024)
- Change Healthcare Cyber Issue Impacting Claims (March 4, 2024)
- Home Health Update: Authorization from Previous Plan Required (March 1, 2024)
- Evolent Health to Manage Services for Neighborhood (February 1, 2024)
- Reminder: Process for Terminating a PCP (February 1, 2024)
- Reinstatement of PCP Required Services (January 1, 2024)
- Requests for Claim Review; Reminders and New Terminology (January 1, 2024)
- Meal Delivery Benefit for New Medicaid Moms (January 1, 2024)
- Home Health Care Services Payment Policy Benefit Limitation and LTSS Waiver Enforcement Frequently Asked Questions (December 20, 2023)
- LunaYou Pilot Program to End in December (December 1, 2023)
- Discontinuation of the LTSS Alternative Payment Model (December 1, 2023)
- Change in Custodial-Level Authorizations for Non-LTSS Members (November 1, 2023)
- Update to Neighborhood’s Telemedicine/Telephone Services Policy (November 1, 2023)
- Policy Update Regarding EVV Requirements for Home Health Agencies (November 1, 2023)
- Neighborhood Postpones Transition of Claim Processing for Commercial Line of Business (September 6, 2023)
- Reminders: Provider Training, Timely Filing, Credentialing Process, Lesser of Logic (September 1, 2023)
- New SNF and Rehab Authorization Request E-Form Now Available (August 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)
- 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 Electronic Claim Submission Requirement (June 1, 2023)
- Notice of Change to G-CSF First Treatment Strategy (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)
- Provider Guidance for Medicaid Members (Adult-Only) Requiring Long-Term Non-Skilled Services (March 1, 2023)
- New Prescribing Requirement for GLP-1 Medications (March 1, 2023)
- Form CMS-1500 Requirements for Neighborhood – Clarification (February 20, 2023)
- Meal Delivery Benefit for Neighborhood Commercial New Moms (February 1, 2023)
- Guidance for NDC Requirement on Medicaid Medical Benefit Claims (February 1, 2023)
- 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)
- Effective March 1, 2022 – Revised Vision Care Services Payment Policy (December 31, 3021)
- 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)
- 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)
- Pharmacy Benefits Manager Transition to CVS Caremark® FAQ (July 31, 2018)
- Behavioral Health Transition to Optum® FAQ (July 31, 2018)
- Letter to providers (August 10, 2018)
- INTEGRITY Reimbursement Logic (September 25, 2018)
- Provider Payment Cycle Update (October 19, 2018)
- Conference Call Details for Q&A Sessions (November 16, 2018)
- Provider Payment Cycle Update (November 1, 2018)