April 2021

Neighborhood’s Medical Management department is pleased to announce the development of a new searchable Prior Authorization Guide.

We have long heard from our providers that the current “table” format is inefficient and the ability to search by code or name would be much more effective.

The new Prior Authorization Reference Guides (Guides) will be available for use on April 1, 2021.   The new Guides will allow providers to enter a procedure/service code or name to obtain authorization information.   The particular code will display with any authorization requirements.  All Guides are available on the Policies and Guidelines webpage of www.nhpri.org.

The Guide does require the Provider to know the member’s line of business to obtain accurate authorization information.   This Guide will be updated on a continuing basis as needed.