July 2021

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Announcements

The Neighborhood Provider Manual was updated July 1, 2021.  Please click here for a summary of changes.

• Provider Appeals Can Now be Emailed to Neighborhood 
• HealthSourceRI offering Special Enrollment Period 
• New DME Network for Neighborhood 
• Annual Provider Training Requirement 
• Change in RA Distribution 
• New Process to Request a PCP Change for a Member

Reminders

• Neighborhood Coding Criteria and Protocols 
• Primary Care Providers (PCP) at Neighborhood 

Behavioral Health

• Follow-Up Care for Children Prescribed ADHD Medications 

Quality Improvement

• Increasing Health Literacy to Improve Health Outcomes 

Payment Policies

• Updated Payment Policies for Obstetrical Services and Physician Services 

Claims

• Claims Corner: Submission Reminders, Electronic Claim Reconsiderations, and Forms 

Pharmacy

• Formulary Changes – Medicaid and Commercial 
• Medically Administered Infusions Available for Administration in the Home 
• How to Bill 340B Appropriately
• Specialty Medication Prior Authorization Criteria – Reminder
• Electronic Prior Authorization (ePA) for the Pharmacy Benefit
• Medical Benefit Prior Authorization Submissions
• Searchable Formulary for Pharmacy Benefit and Medical Pharmacy Medications

The News and Updates section of the Neighborhood website is used to share important news and information, including notifications on payment policies, operational issues, and more.