|
|
|
| June, 2010
|  |
Greetings!
I hope this message finds you well, enjoying some vacation time and otherwise finding cool alternatives to our very warm current temperatures.
Please find below a brief list of important Neighborhood Health Plan (NHP) updates.
|
| Provider Manual Updates | | |
Our online Provider Manual has undergone extensive revisions, including a new look consistent with our corporate image.
The new Manual includes important updates on doing business with NHP and helpful links to new information. The Manual will be updated several times a year, with providers notified accordingly.
Click below to view our new Provider Manual and let us know what you think. We welcome your feedback for enhancing this important provider reference tool.
Information on new benefit updates effective July 1, 2010 will be communicated via separate notice and as part of these NHP monthly updates. |
|
| Enhanced Fax Process for Pharmacy Prior Authorization Requests
| |
NHP now offers a single point of contact for faxing pharmacy authorization requests.
Coverage requests for medications subject to prior authorization requirements should be submitted directly to MedMetrics Health Partners at 1-800-918-7542.
Most requests can be processed within 24 hours. For urgent requests, providers should call the 24 hours MedMetrics Prior Authorization Line at 1-800-918-7550.
|
| NHP Provider Operations Meeting | | | Save the date for our next meeting scheduled for Wednesday, August 11th. The agenda will include a demonstration of our provider self-service options and other important information.
An agenda and registration information will be provided in the coming weeks.
We look forward to seeing you!
|
|
| A New NHPNet | | |
We have been busy working on enhancements to our provider portal, NHPNet.
Scheduled to be available in July, NHPNet now offers new features, enhanced reports, new user management options and much more!
Please look for a separate notification in the next few days specific to the new portal, including a user guide and other important information.
|
| Harvard Vanguard Medical Associates Patient Referrals | | |
We want to remind you that effective July 6, 2010, all NHP members with a Harvard Vanguard Medical Associates PCP will be required to obtain an appropriate referral from their PCP when seeking care from a non-Harvard Vanguard specialty provider.
Referrals are not required for the following:
- A Gynecologist or Obstetrician for routine, preventive, or urgent care
- Family planning services provided by an NHP provider
- Outpatient and diversionary Behavioral Health Services
- Emergency services
NHP is making these changes to help enhance care coordination for those NHP members with a Harvard Vanguard primary care provider (PCP).
This referral requirement applies to Harvard Vanguard patients participating in all NHP plans: Commercial, Commonwealth Choice, Commonwealth Care, CMA, and MassHealth. Please note that for NHP members who are enrolled through the Group Insurance Commission (GIC), this change is effective for services rendered on or after September 1, 2010.
To avoid claims denials, providers should verify the existence of an appropriate referral for members with a Harvard Vanguard PCP prior to services being rendered.
Those members affected by this change as well as the NHP provider community, have been notified of the new referral requirements. As always, please contact your Provider Relations representative directly with any questions or our Customer Care Center at 800-462-5449. |
| Upcoming Massachusetts Patient-Centered Medical Home Initiative | | |
We wanted to share with you, particularly primary care provider practices interested in applying, important information regarding a multi-payer Patient-Centered Medical Home (PCMH) initiative starting soon in Massachusetts.
Among other benefits, selected practices will have the opportunity to participate in a three year transformation plan that includes:
- Attending learning collaborative sessions
- Working with medical home facilitators
- Submitting patient registry-based reports
- Applying for National Committee for Quality Assurance (NCQA) medical home recognition.
Click here for detailed information about this initiative, the application process and corresponding deadlines.
|
| Thank 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 all the collaboration extended to our staff. Best regards,
Ramona Bourguignon
Director of Provider Relations Neighborhood Health Plan
ramona_bourguignon@nhp.org |
| Your Current NHP Profile Information |  | |
NAME:
TITLE:
COMPANY NAME:
PROVIDER TYPE:
CONTRACTED Y/N:
ZIP CODE:
Please Note: the profile information listed above is based on data provided to NHP by the recipient and used for our mailing list. To view/edit your profile information please click here:
For all other questions, please contact the Provider Relations department at prweb@nhp.org. |
|
|
|
|
|
|
