Long Term Services and Supports (LTSS) is a benefit available to members with chronic illnesses or disabilities who need a certain level of care and meet the eligibility criteria. The type of services a member receives depends on the level of care needs.

Lines of Business

• Commercial: Does not have an LTSS benefit.
• Medicaid: Members who qualify for an LTSS waiver are managed out-of-plan by Medicaid fee-for-service (FFS). Authorizations and claims for these services are processed through FFS.
• INTEGRITY for Duals: Both Medicare and Medicaid LTSS services are managed by Neighborhood.
• Dual CONNECT: Neighborhood manages only the Medicare benefits. LTSS Medicaid benefits are managed directly by the state. Providers must obtain authorization and bill the state for Medicaid-covered services.

LTSS Services

LTSS services include, but are not limited to:

News and Updates

Below is a list of all LTSS-related news items, for more updates please go to our News and Updates page.

Neighborhood Provider Resources

• Provider Homepage
• Provider Manual
• Quick Reference Guide
• Navinet
• Claims and Eligibility
• Prior Authorization Search Tool
• D-SNP
• Claim Form Finder
• Provider Orientation
• Provider Training
• Provider Newsletter
• Update Your Information
• Provider Questions? We Have Answers.

Neighborhood LTSS Forms

• LTSS Application Assistance Referral Form
• Member Education Request Form
• Appointment of Representative (AOR) Form
• Adult Day Prior Authorization Form
• Assisted Living Prior Authorization Form
• Home Care Discharge Communication Form
• Home Care Services Prior Authorization Form (Home Care Prior Authorization Form Guide)
• Skilled Nursing Facility Prior Authorization Form
• Provider Clinical Appeal Form

EOHHS Resources

• EOHHS LTSS Provider Resources
• EOHHS LTSS Member Resources
• Home And Community Based Services Medical Coverage Guidelines
• Medicaid LTSS Waiver Application
• EOHHS Healthcare Portal