Click here for quick access to all posted Payment Guidelines.  

To inquire about a Payment Guideline not currently listed, just e-mail us at prweb@nhp.org.

In our last edition we featured this report provided by NHP to address the challenges of improving asthma care via the proactive identification of patients struggling with asthma control.   

 
We are pleased to confirm that the report is now available electronically on NHPNet!

This report identifies NHP patients with problematic asthma control defined as:

• A recent asthma related ER visit; or
• Recent high use of quick relief medication and/or systemic steroids. 

It lists relevant asthma-related utilization (by service date over the past 4 months) of the following services:

-          Quick relief medications (dispensed)

-          Systemic steroids (dispensed)

-          Controller medications (dispensed)

-          Asthma emergency room visits

-          Asthma hospitalizations

-          Asthma specialist visit

We will continue faxing this report over the next 6-8 weeks while providers make needed adjustments. To begin accessing the report electronically now, please log in to your NHPNet account or contact your appointed NHPNet User Administrator. For additional assistance or to verify your appointed User Administrator's name, email Provider Relations at prweb@nhp.org.

As always, we welcome your feedback on these and all other utilization reports. Providers with questions specific to this new Asthma Trigger Report can contact NHP's Asthma Case Managers Cindy Cookson (617-478-7181 or cindy_cookson@nhp.org) or John Pruett (617-772-5641 or john_pruett@nhp.org).

With regard to medication use, members are included in the report if they have:

1.  Filled a prescription for either a quick relief medication (beta-agonist trigger) or a systemic steroid (systemic steroid trigger), AND
2. Filled at least 3 prescriptions for a quick relief medication (beta-agonist trigger) or a systemic steroid in the past 4 months.

No More Faxing Prior-Authorization Requests

We want to thank all of you who have contacted us inquiring about the online prior-authorization requests options we recently announced.

There's obviously a lot of interest from providers in not having to contact the Plan for assistance with routine transactions. It's completely OK. We don't take it personally :)  

Our new FREE option for submitting prior-authorization requests to NHP electronically (and eliminate faxing, mailing, calling to check status, etc) is just one more way of us recognizing that your time is very valuable. Interested in submitting online prior authorization requests? Email our Senior EDI Analyst, Vin Chiachio at vincent_chiachio@nhp.org. Vin will gladly answer any questions you may have or help getting you started.  

We continue to look for ways to streamline how you do business with us. Please send us your feedback to prweb@nhp.org  or contact your NHP Provider Relations representative directly.

Clinician Quarterly Provider Newsletter