Claims Corner

April 2021

Claim Submission Reminders for Providers and Billers

  1. Neighborhood uses technology to scan paper forms and eliminate keystroke errors. All new and corrected paper claims must be submitted on original (not photocopied) print versions of the industry standard CMS-1500 and CMS-1450 (UB-04) forms, as they are printed in special optical character recognition (OCR)-scannable red ink.
  2. Claim forms must not contain any handwritten elements, stamps, correction fluid, or staples.
  3. Data entered on the claim form must be properly aligned and fall completely within the applicable text fields. Data that is misaligned or ghosted elsewhere on the form is systematically recognized as an error and will result in the claim being returned to the sender for correction.
  4. It is not necessary to provide a W-9 form with a claim unless it is the first time a claim is submitted to Neighborhood on a non-participating provider’s

Current Forms

Please remember to use the most current request forms available on our website.  Provider request forms are available in the Forms section of the Provider Resources menu on the Neighborhood website.  The Corrected Claim, Reconsideration, and Appeal request forms are writeable, so they can be typed online, then printed and submitted to Neighborhood.  Outdated forms will be returned to the sender for correction.

For help deciding which form to use, the Claim Form Finder, located in the Forms section of the Provider Resources menu on the Neighborhood website can help to determine which form must be completed and submitted to Neighborhood, along with additional information related to the submission of each form.

Provider Manual

Section 4 of Neighborhood’s 2021 Provider Manual contains updated information regarding claim billing and reimbursement.  For questions or concerns, Provider Services representatives are available Monday through Friday, 8:00am – 6:00pm EST at (800) 963-1001.