Recent News for Neighborhood Providers
2026
Update to 835 Reporting for INTEGRITY for Duals Claims (June 10, 2026)Home Health Care Services Payment Policy Updates (June 5, 2026)Updates to Provider Remittance Advice/Explanation of Payment (June 3, 2026)Hearing Aid Repair Claims Requiring Invoice Documentation (May 27, 2026)Home Infusion Billing Reminder for D-SNP Claims (May 27, 2026)Deemed Eligibility Coverage Reminders (May 27, 2026)Skilled Nursing Facility Claims Submission Guidance for INTEGRITY for Duals (May 21, 2026)Skilled Home Health Claims Submission Guidance for INTEGRITY for Duals (May 20, 2026)Updated Payment Policies INTEGRITY for Duals and Dual CONNECT (May 15, 2026)No Prior Authorization Requirement for Services Ordered by PCPs – Medicaid and Commercial (May 15, 2026)Updated LTSS Payment Policies – INTEGRITY for Duals and Dual CONNECT (May 1, 2026)COB Submission Process for CCBHC Claims (May 1, 2026)Authorization Requirement Update – Interventional Cardiology (Medicaid) (May 1, 2026)Coding Change for Home Health Aide Services – Commercial (May 1, 2026)Important Billing Guidance for Nursing Facility Claims for INTEGRITY for Duals and Dual CONNECT (April 17, 2026)Important Billing Guidance for Skilled Home Health Claims for INTEGRITY for Duals and Dual CONNECT (April 17, 2026)Updated Payment Policies – INTEGRITY for Duals and Dual CONNECT (April 6, 2026)New Streamlined Address Update E-Form Now Available (April 3, 2026)Issue Resolved: Claim Adjustment Submissions for INTEGRITY for Duals and Dual CONNECT (April 2, 2026)New Sexually Transmitted Infection (STI) Testing Payment Policy (April 1, 2026)Durable Medical Equipment (DME) Authorization Requirement Changes (April 1, 2026)Important Reminder: Member Billing for INTEGRITY for Duals (March 23, 2026)New EDI Support Form Available for Claims Submission and ERA Inquiries (March 20, 2026)Temporary Process for Submitting Claim Adjustments – INTEGRITY for Duals and Dual CONNECT (March 6, 2026)Clarification of INTEGRITY for Duals Electronic Remittance Advice Format (March 3, 2026)Update to Enhanced Adult Day Health Coverage for INTEGRITY for Duals Members (March 1, 2026)Update to Personal Emergency Response System (PERS) Coverage for INTEGRITY for Duals Members (March 1, 2026)Assisted Living Tier Change Process Update (February 26, 2026)Clarification to Prior Authorization Submission Requirements (February 23, 2026)Delayed Processing of INTEGRITY for Duals Home Care Claims with Service Modifiers (February 19, 2026)Prior Authorization Updates for Select Genetic Testing Codes (February 17, 2026)Required Medical Evaluation Form for SNF LTSS Waiver Submissions (February 16, 2026)Important Update Regarding 2025 1099 Tax Forms (February 11, 2026)Assisted Living Claims Submission Format – INTEGRITY for Duals (February 6, 2026)Important Update 835 Remittance Advice Unavailable for D-SNP Claims (February 4, 2026)Adult Day Services Authorization Reminder (January 22, 2026)Temporary Behavioral Health Eligibility Support Inbox Closing March 1, 2026 (January 22, 2026)New LTSS Provider Resource Page Available (January 21, 2026)Incorrect Claim Submissions Related to D-SNP Transition (January 12, 2026)Payment Policy Updates: Prolonged Clinical Monitoring (January 1, 2026)
2025
Non-Emergent Ambulance Transportation Prior Authorization Requirement – INTEGRITY for Duals and Dual CONNECT (December 31, 2025)Behavioral Health Cost Sharing Now Displaying in NaviNet for Commercial Members (December 26, 2025)Prior Authorizations for Members Transitioning from Neighborhood INTEGRITY (MMP) to Neighborhood INTEGRITY for Duals (December 22, 2025)Chiropractic Services Benefit Update – Medicaid (December 17, 2025)Provider Communications Survey (December 10, 2025)Custodial Care Authorization Update for INTEGRITY for Duals Members (December 1, 2025)Reminder: Important Update for Members Enrolled in Medicare and Medicaid (December 1, 2025)LTSS Application Assistance Referral Form Now Available (November 26, 2025)Prior Authorization Submission Clarification for Chiropractic Services (November 24, 2025)Preadmission Screening and Resident Review (PASRR) Requirement for Skilled Nursing Facility Requests (November 1, 2025)NaviNet Registration Steps for Contracted Providers (October 24, 2025)Reduced Turnaround Time for Standard Prior Authorization Requests – Medicare and Medicaid (October 24, 2025)Updated Provider Training and Provider Manual for 2026 (October 15, 2025)INTEGRITY (MMP) Behavioral Health Claim Payment Update (October 10, 2025)Action Required: Mandatory Fall 2025 Provider Training (October 1, 2025)Credentialing Reminder for Nurse Practitioners in Behavioral Health (September 29, 2025)Behavioral Health Frequently Asked Questions (September 25, 2025)Important Update for Members Enrolled in Medicare and Medicaid (September 24, 2025)Temporary Eligibility Support Inbox Available (September 18, 2025)Proper Submission of Taxpayer Identification Numbers (TINs) (September 10, 2025)Proper Use of Member Identification Numbers When Submitting Claims (September 5, 2025)Behavioral Health Services Now Managed In-House at Neighborhood (September 1, 2025)Updated Prior Authorization Requirements for Medicaid and Commercial Lines of Business (August 29, 2025)Behavioral Health Orientation Q&A Recap and Upcoming Session (August 22, 2025)Delegation of Joint/Spine Surgery and Interventional Cardiology Services to Evolent (August 21, 2025)Required Claim Submission Changes for CCBHCs Effective September 1 (August 18, 2025)Update to Authorization Requirements for Home Health Nursing Assessments (August 1, 2025)Register for NaviNet Acces s (July 29, 2025)Join Neighborhood for an In-Person Behavioral Health Provider Orientation (July 14, 2025)Updated Home Health Agency Payment Policy Now Available (July 7, 2025)Behavioral Health Orientation Q&A Recap and Upcoming Sessions (July 3, 2025)Prior Authorization Continuity for Members Affected by Recent PCP Closures (June 26, 2025)Reminder: LTSS Waiver Requirement for INTEGRITY (MMP) Members in Skilled Nursing Facilities (June 13, 2025)Reminder: Behavioral Health Webinars Scheduled for Summer 2025 (June 4, 2025)Claim Submission Reminders: Corrected and Duplicate Claims (May 30, 2025)Reminder: LTSS Approval Required for Home Care Hours Above Preventive Level – INTEGRITY (MMP) (April 25, 2025)Telemedicine Policy Updates (April 25, 2025)New Streamlined Home Care Prior Authorization Forms Now Available (April 24, 2025)Neighborhood to Manage Behavioral Health Services Beginning September 1, 2025 (March 4, 2025)Implementation of Transportation Payment Policy (March 1, 2025)NaviNet’s New Feature: Patient List (February 14, 2025)Improved Process for Home Care Grid (February 3, 2025)Update to Secondary Claim Submission Timeframe (February 1, 2025)Health Risk Assessment Reminder (January 31, 2025)Update on Appeals for Post-Service Authorizations (January 14, 2025)Provider Questions? We Have Answers (January 14, 2025)Neighborhood to Expand Evolent Physical Medicine Program (January 1, 2025)Update to Low-Dose CT Scan Authorization Requirement (January 1, 2025)Update to Maternal Meal Delivery Program (January 1, 2025)
2024
Important Update on Billing Codes for Home Health PT/OT/ST Services & Behavioral Health State Enhancement Reimbursement Rate Changes (December 20, 2024)Changes to Authorization Requirements for Select Services Under Medicaid and Commercial Lines of Business (November 1, 2024)Prior Authorization Requirements Removed for Select Commercial Home Health Care Services (November 1, 2024)Changes to Acupuncture Coverage for Commercial Members (November 1, 2024)Reminder: Sterilization Consent Form for Medicaid Members (November 1, 2024)INTEGRITY (MMP) Line of Business Added to Vitamin D Testing Policy (November 1, 2024)Reminder: INTEGRITY (MMP) Medicare Requirements (November 1, 2024)Process Update: Submitting Explanation of Benefit Information (November 1, 2024)Changes to Provider Appeals Submission Process (October 1, 2024)Prior Authorization Requirements Removed for Chiropractic Services (October 1, 2024)Neighborhood Clearinghouse Update (September 13, 2024)Reminder: Use of Corrected/Voided Claim Request Form (September 1, 2024)New Documentation Requirements for Adult Day Services (August 28, 2024)New Documentation Requirements for Pediatric Home Health Services; Billing Reminder (August 28, 2024)Post-Service Prior Authorizations No Longer Accepted for MMP Line of Business (August 7, 2024)Reminder: Documentation Requirements for Pain Management Prior Authorizations (May 22, 2024)New Reimbursement Rate for Occupational and Physical Therapy Services (May 15, 2024)Home Health Care Prior Authorization Requirement to be Removed (May 9, 2024)Vision, Medical Prior Authorization Requirements to be Removed (May 9, 2024)Update to Neighborhood’s Access to Care Standards for INTEGRITY Members (May 1, 2024)New Documentation Requirements for Plastic Surgery Procedures (May 1, 2024)Neighborhood Reconnected to Change Healthcare (April 15, 2024)Update to Provider Appeals Submission Process (April 1, 2024)New Vitamin D Testing Policy for Medicaid and Commercial Members (April 1, 2024)Important Updates to Claim Processing for Neighborhood’s Commercial Line of Business (March 27, 2024)Reminder: Claims Processing Policy for Modifier 25 (March 26, 2024)Update: Delegation of Services to Evolent Delayed to June (March 18, 2024)Change Healthcare Cyber Issue Impacting Claims (March 4, 2024)Home Health Update: Authorization from Previous Plan Required (March 1, 2024)Evolent Health to Manage Services for Neighborhood (February 1, 2024)Reminder: Process for Terminating a PCP (February 1, 2024)Reinstatement of PCP Required Services (January 1, 2024)Requests for Claim Review; Reminders and New Terminology (January 1, 2024)Meal Delivery Benefit for New Medicaid Moms (January 1, 2024)
2023
Home Health Care Services Payment Policy Benefit Limitation and LTSS Waiver Enforcement Frequently Asked Questions (December 20, 2023)LunaYou Pilot Program to End in December (December 1, 2023)Discontinuation of the LTSS Alternative Payment Model (December 1, 2023)Change in Custodial-Level Authorizations for Non-LTSS Members (November 1, 2023)Update to Neighborhood’s Telemedicine/Telephone Services Policy (November 1, 2023)Policy Update Regarding EVV Requirements for Home Health Agencies (November 1, 2023)Neighborhood Postpones Transition of Claim Processing for Commercial Line of Business (September 6, 2023)Reminders: Provider Training, Timely Filing, Credentialing Process, Lesser of Logic (September 1, 2023)New SNF and Rehab Authorization Request E-Form Now Available (August 1, 2023)Important Updates to Claim Processing for Neighborhood’s Commercial Line of Business (August 1, 2023)Radiology Services Appeal Process Change (August 1, 2023)Update: Form CMS-1500 Requirements for Neighborhood (July 6, 2023) – Originally appeared in July 2023 Provider Newsletter Delay in Home Care Gap Notification Form Implementation (June 16, 2023)Notice of Electronic Claim Submission Requirement (June 1, 2023)Notice of Change to G-CSF First Treatment Strategy (June 1, 2023)Pharmacy Webpage Restructuring (May 15, 2023)Improved Process for Home Care Gap Notification Form (May 15, 2023)Home Care Gap Notification (April 28, 2023)Provider Guidance for Medicaid Members (Adult-Only) Requiring Long-Term Non-Skilled Services (March 1, 2023)New Prescribing Requirement for GLP-1 Medications (March 1, 2023)Form CMS-1500 Requirements for Neighborhood – Clarification (February 20, 2023)Meal Delivery Benefit for Neighborhood Commercial New Moms (February 1, 2023)Guidance for NDC Requirement on Medicaid Medical Benefit Claims (February 1, 2023)
2022
Neighborhood is Removing Select Prior Authorization Requirements in 2023 (December 1, 2022)Neighborhood Crossing Enhancements in 2023 (November 1, 2022)Rhode Island Expands Monkeypox Vaccination Efforts (August 4, 2022)New and Improved Process for Requesting Interpreter Services (May 31, 2022)New Telemedicine/Telephone Services Payment Policy, Effective July 1, 2022 (May 1, 2022)Improved Process for Claim Reconsideration Requests – eForm Required June 1, 2022 (April 1, 2022)Revised Speech Therapy Services Payment Policy – Effective May 1, 2022 (February 24, 2022)Revised Physical and Occupational Rehabilitation Services Payment Policy – Effective April 1, 2022 (February 1, 2022)Acupuncture Services Payment Policy for Neighborhood Commercial Members (February 1, 2022)Reinstatement of Temporary Telemedicine/Telephone-Only Payment Policies (January 28, 2022)
2021
Effective March 1, 2022 – Revised Vision Care Services Payment Policy (December 31, 3021)DME Device Voluntary Recall Alert (November 30, 2021)Updated Timeframes for Claim Submission and Review Processing (November 9, 2021)Delayed Provider Payment for Medicaid (November 4, 2021)Improved Process for Requesting Adjustments to Multiple Claims (October 1, 2021)Provider Notification – Professional and Facility Industry Standard Coding Requirements Regarding Bundled Billing (September 1, 2021)Provider News – Claims Submission Requirement Reminder for Institutional Claims (July 26, 2021)Provider News – DME Network Change (June 28, 2021)Provider Notification – Annual Provider Training Requirement (June 21, 2021)Provider Notification – Notice of Change in Remittance Advice Distribution (June 15, 2021)Provider Notification – Neighborhood Clinical Medical Policy Procedure Reminder (June 8, 2021)Provider Notification – Updated Neighborhood Health Plan of Rhode Island Payment Policies and New Archive Webpage (June 1, 2021)Provider Notification – Revised Payment Policies for Physical and Occupational Rehabilitation Services and Speech Therapy Services (April 30, 2021)Provider Notification – Update Your Information and Email Registration (April 2, 2021)Potential Delayed Provider Payments for Medicaid (January 8, 2021)Effective January 1, 2021 – Updated Payment Policy for Hospital Readmissions (January 7, 2021)