Neighborhood Health Plan
Neighborhood Health Plan Provider News
In This Issue
Provider Enrollment Updates
Provider Service Line Updates
Wait Time Access Survey
Payment Policy Changes
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June 2013
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Please find below a list of important Neighborhood Health Plan updates.
Provider Enrollment Updates   
New! Provider Enrollment and Credentialing  Email Address
Beginning June 1, 2013, please submit the following Provider enrollment transactions to the new email address: 
  • Submission of HCAS forms
  • Termination requests
  • Effective date inquiries
  • Requests to change PCP panel status
  • Provider demographic changes
  • Requests to become a participating provider  

The HCAS form has been updated to reflect the new email address. Please submit transactions with the new form only to assist in the timely processing of your request.    


Re-credentialing Inquiries


As a reminder,  it is important to respond timely to credentialing and re-credentialing inquiries.  Failure to respond timely may result in significant delays in processing your application and possible termination from the network.     


New Provider Service Line Prompts     

As previously communicated, we are making enhancements to our Provider Service Line  (1-855-444-4NHP). The implementation date for the enhancements has changed from June 2013 to July 2013. 

Beginning mid July 2013, when calling our provider service line,  you will receive a prompt to enter your NPI number and the Member ID. These enhancements will  assist with timely responses to your phone inquiries. 

As a reminder, our provider portal (NHPNet) remains available 24 hours a day, 7 days a week to provide access to many transactions within seconds and without a dependency on Provider Service staff.  
Wait Time Access Survey
Reminder to Primary Care Providers

At Neighborhood Health Plan we find it important to understand our members wait time experiences at provider offices.  We are asking Primary Care and Specialty practice sites to complete one survey per practice so we can improve our understanding of member wait time experiences as well as supply required reporting information to NCQA.

Please access the survey by clicking here or copying and pasting the link into your web browser.

We appreciate the care you provide to our members and thank you in advance for supporting this important effort.  Please don't hesitate to email with additional questions.

Payment Policy Changes

Neighborhood Health Plan (NHP) will be implementing the following payment policy changes for all lines of business effective August, 1, 2013:

After Hours Add on Code (99051)

Effective August 1, 2013, for all lines of business, NHP will no longer reimburse CPT code 99051 (services provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service). However, we will continue to reimburse CPT code 99050.

High Tech Radiology Codes

Also effective August 1, 2013, to better align with industry standards, NHP will no longer reimburse the following radiology codes:
  • 0159T- Computer aided detection, including computer algorithm analysis, breast MRI
  • G0219-PET imaging whole body; melanoma for non-covered indications
  • G0235-PET imaging, any site, not otherwise specified 

Bundled Codes/Services

Effective, August 1, 2013, for all lines of business procedures performed at the same time as a primary procedure (see list below)  are considered inclusive to the primary procedure and will not be reimbursed separately.




Hot or cold packs therapy


Ex for nonspeech device rx


Genetic counseling 30 min


Sp bone agrft local add-on


Place needle in vein


Vital capacity test


Home health care supervision


Sp bone algrft morsel add-on


Remove sutures same surgeon


Postop follow-up visit


Non-speech device service


Home vent mgmt supervision


Occlusive device in vein art


Wound(s) care non-selective


Self-mgmt educ & train 1 pt


Caloric vestibular test


Permanent tear duct plug


Disposable endoscope sheath


Anticoagulant mgmt subseq


Emergency anesthesia


Collect/review data from pt


Positional nystagmus test


Surgical trays


Office emergency care


Hospice care supervision


Anticoagulant mgmt initial


Patient education materials


Team conf w/o pat by phys


Self-mgmt educ/train 2-4 pt


Group health education


Self-mgmt educ/train 5-8 pt


Temporary tear duct plug


Thank You!
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 

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.
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