Neighborhood News
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Announcements
- Assisted Living Claims Submission Format – INTEGRITY for Duals
- Assisted Living Tier Change Process Update
- Durable Medical Equipment (DME) Authorization Requirement Changes
- Issue Resolved: Claim Adjustment Submissions for INTEGRITY for Duals and Dual CONNECT
- New EDI Support Form Available for Claims Submission and ERA Inquiries
- New Streamlined Address Update E-Form Now Available
- Provider Spotlight Series
- Required Medical Evaluation Form for SNF LTSS Waiver Submissions
- Update to Enhanced Adult Day Health Coverage for INTEGRITY for Duals Members
- Update to Personal Emergency Response System (PERS) Coverage for INTEGRITY for Duals Members
Claims
Payment Policies
- New Sexually Transmitted Infection (STI) Testing Payment Policy
- Updated Payment Policies – INTEGRITY for Duals and Dual CONNECT
Pharmacy
- How to Bill 340B Appropriately
- Medicaid Pharmacy Benefit Updates
- Medicaid and Commercial Limited Specialty Pharmacy Network Coverage Update
- Medical Pharmacy Benefit Updates
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
Monthly Pharmacy Benefit Changes: On a monthly basis, Neighborhood places a list of formulary changes on its website for each line of business. For more information, please visit the Pharmacy Provider Resources webpage.
Prior Authorization
- Clarification to Prior Authorization Submission Requirements for Medicaid and Commercial Lines of Business
- Important Authorization Steps for High End Radiology and Interventional Cardiology Providers
- Prior Authorization Updates for Select Genetic Testing Codes
- Specialty Medication Prior Authorization Criteria
Quality Improvement
- Asthma Medication Ratio
- Human Papillomavirus Awareness and Vaccination
- Kidney Health Evaluation for Patients with Diabetes
- STI Awareness Week 2026
Reminders
- Delegation of Joint & Spine Surgery and Interventional Cardiology Services to Evolent
- Important Reminder: Member Billing for INTEGRITY for Duals Members
- Mandatory Provider Training
- Medicare Beneficiary Identifier (MBI) on MDS Assessments in Skilled Nursing Facilities
Risk Adjustment
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.