In a previous issue we informed you of our efforts to streamline the process for delivering these regulatory reports. Currently available primarily on paper, these quarterly reports provide participating facilities with demographics, prior-authorization and other information on all NHP members admitted to the facility during the preceeding quarter.

 

We have spent the last few weeks engaged in the associated testing and within the next few days will notify current report recipients of how to access the next set of reports on a self-service capacity via our provider portal, NHPNet.

 

Please contact your dedicated NHP Provider Relations representative in the meantime with specific questions on the reports or current recipient for your facility.

As you may be aware, MassHealth's enrollment process for newborns born to mothers enrolled in a Managed Care Organization such as NHP requires that the facility notify their Enrollment unit via the Notification of Birth (NOB) form. This MassHealth proprietary form captures demographic information for both mother and child, in addition to confirming the mother's health plan selection for the newborn.

 

We would like to remind network facilities of the critical need to submit the fully completed NOB to MassHealth timely and indicating the health plan chosen by the mother. Failure to properly notify MassHealth often results in retroactive enrollment changes and the associated post-payment recoveries. While health plans cannot notify MassHealth directly of these newborns, we  are currently reviewing the process for alerting facilities of babies born to NHP enrolled members in hopes of increasing the notification compliance rate. 

 

Please share this information with relevant personnel within your organization. For questions on completing the NOB, please contact Provider Relations at prweb@nhp.org 

 

NHP's provider portal offers users the option of appointing a specific individual to manage user accounts. In this role, the NHPNet Site Administrator is responsible for approving user accounts for his/her respective organization and adding/terminating accounts for new and former employees as needed. The Site Administrator also determines the level of access each NHPNet user should have based on the individual's specific role. 

 

Site Administrators should review their NHPNet user list regularly to ensure accuracy of user rights resulting from staffing and other changes.

 

Over the next few weeks, our Provider Relations staff will be reaching out to all Site Administrators asking them to validate the NHPNet user roster for their respective entities. For  questions about NHPNet user lists, please contact your Provider Relations representative directly or email our department at prweb@nhp.org.

 

Our menu of Provider Payment Guidelines has expanded to include the following new and/or revised guidelines:

For a full list of NHP payment guidelines, please click here:

Provider Payment Guidelines 

 

We thank you for your support in consistently sending representatives from your office. We value their contributions and interactive participation and use feedback collected through these meetings to improve how we do business with you.

On behalf of the Provider Relations department and all of us at NHP, thank you for your continuing excellent care of our members and collaboration extended to our staff.

 

Best regards,

Ramona Bourguignon
Director of Provider Relations
ramona_bourguignon@nhp.org 

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