COVID-19 Provider Guidance
Neighborhood is grateful to our network providers for the care and response provided to our members during the COVID-19 pandemic. In an effort to assist you in working with Neighborhood during this evolving situation, we have compiled a list of frequently asked questions and answers regarding COVID-19.
Below are Neighborhood’s COVID-19 payment policies:
COVID-19 Vaccine Payment Policy – Updated
Temporary COVID-19 Prior Authorization Policy
Temporary COVID-19 Telemedicine/Telephone-only
Temporary COVID-19 Telemedicine/Telephone-only Preventive Medicine Visits
Temporary COVID-19 Testing and Treatment Services Policy
Temporary COVID-19 Triage Services Provided by Telephone – *This policy was effective for dates of service prior to March 18, 2020. This policy was terminated March 18, 2020 and replaced with the payment policy for Temporary COVID-10 Telemedicine/Telephone-only.
Throughout this challenging time, Neighborhood has worked closely with the Rhode Island Department of Health, the Rhode Island Office of the Health Insurance Commissioner (OHIC), the Executive Office of Health & Human Services, and other health experts to understand the impact to our members, providers, as well as, our own business. This page will be updated as more information becomes available.
What is Neighborhood’s temporary COVID-19 prior authorization policy?
Who should be tested for COVID-19?
What ICD-10 code should I use to diagnosis COVID-19?
How can providers help with vaccine outreach?
Do telemedicine services provided via telephone require an authorization?
Is Neighborhood’s temporary telemedicine payment policy for telephone only?
Will Neighborhood and Optum waive co-pays for behavioral health care services?
Is Neighborhood updating policies and procedures as a result of State and Federal guidance regarding COVID-19?
Has Neighborhood waived the PCP assignment/requirement for members during COVID-19?
Is Neighborhood offering a benefit exception for any durable medical equipment (DME)?
Will Neighborhood “emergency credential” providers during the State of Emergency?
Are there updates to pharmacy coding to allow for early refills or extended day supplies?
Is Neighborhood expected to change their retro-authorization timeline to more than 3 business days should a larger outbreak of the virus occur and hospital admissions increase?
Will Neighborhood waive deductible and/or cost-sharing requirements for Commercial members with costs related to COVID-19 testing?
Is Neighborhood covering services to support telephonic triage of COVID-19 symptoms with Neighborhood members?
Will Neighborhood waive referral requirements for members seeking testing or treatment for COVID-19?
What else is Neighborhood doing to address COVID-19?
Additional Resources
- Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (From CMS on January 7, 2021)
- COVID-19 Long-Term Care Facility Guidance (From CMS on April 2, 2020)
- Telehealth Toolkits for General Practitioners and ESRD Providers (From CMS on March 20, 2020)
- General Provider Telehealth and Telemedicine Tool Kit (From CMS on March 17, 2020)
Last updated:
Previous Updates: Mar 10, 2020 @ 4:46 pm; Mar 6, 2020 @ 5:08 pm