Greetings!
Happy New Year! Please find below a list of important Neighborhood Health Plan updates. |
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Online Authorization & Referrals Implementation |
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Please be aware, effective February, 2012, Prior Authorizations for all members and Referrals for MassHealth & Commonwealth Care members must be submitted through NHPNet. Only requests for benefit exceptions and out of network providers can be initiated by fax.
If you haven't done so already, we strongly encourage you and your staff to use this additional time to register for the portal at the following link: www.nhpnet.org.
As a precursor to implementation, NHP has developed Quick Start guides to show you how simple it will be to enter authorizations and referrals via the portal. Please review the PDFs located on the Provider News section of NHP.org.
As a reminder, specialty referrals will be required for all services/specialists except the following:
- A Gynecologist or Obstetrician for routine, preventive, or urgent care
- Family planning services provided by any MassHealth or Commonwealth Care provider
- Outpatient and diversionary Behavioral Health Services
- Emergency services
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Text4Baby |
Help your patients obtain support throughout their pregnancy and babies first year with FREE text messages on topics like prenatal care, baby health, parenting and more! Make sure your patient is "One Smart Mom" by encouraging her to sign up for Text for Baby. Simply have her text BABY or BEBE (Spanish) to 511411 to participate.
http://www.text4baby.org/ |
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HIPAA 5010 Update |
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NHP is now ready to convert trading partners to 5010. Based on the recent notice from CMS (Centers for Medicare & Medicaid Services), the new 5010 conversion deadline is 3/31/2012. Because of the 90-day 5010 conversion grace period, we will not be doing a mass conversion on 12/31/2011. We will convert on an ad hoc basis through 3/31/2012, as trading partners notify us that they are ready. The conversion process may require as little as 24 hours, but we expect the average to be 48 to 72 hours.
Please contact us and schedule a date for conversion. We will decide upon a date to receive the final 4010 transactions, and then we will start the conversion process. When it is complete, we will notify trading partners that they can begin sending 5010 transactions.
Please send an email to Vin Chiachio (Vincent_Chiachio@nhp.org) with a CC to both Ken Brooks (Kenneth_Brooks@nhp.org) and your Provider Relations Representative to setup your conversion timeline. |
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Provider Appeal Form |
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When submitting a provider appeal, please remember to use the Request for Claim Review Form. This standard form may be utilized to submit a claim for additional review. Please refrain from using any other forms/templates when submitting appeals.
Appeals may be sent to:
Mail
Neighborhood Health Plan
253 Summer Street
Boston, MA 02210
Fax
617-772-5511
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Provider Technology Adoption Survey |
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Health plans are required to submit provider technology adoption information to the Massachusetts Division of Health Care Finance and Policy as part of the All-Payer Claims Database initiative (114.5 CMR 21.00 in accordance with M.G.L. c. 118G).1 The Division is the Massachusetts state agency created to support transparency and increase quality and efficiency in the health care delivery system.
In an effort to assist health plans to collect provider technology adoption information and to avoid duplicate data requests, HealthCare Administrative Solutions (HCAS) developed a survey to collect provider information to comply with the state requirement and to assess provider technology use in the state. Providers are asked to complete the survey below. The information provided will be submitted to the Division of Health Care Finance and Policy and to the health plans you designate at the end of the survey.
https://www.hcasma.org/Survey.aspx
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| Thank You! |
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On behalf of all of us at Neighborhood Health Plan, we thank you for the excellent care provided to our members and the continued collaboration extended to our staff.
Provider Relations Department
Neighborhood Health Plan
prweb@nhp.org
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| Your NHP Profile Information |
Please Note: the information above is based on data provided to NHP and voluntarily updated by the recipient. To update your contact information click here. |
