Provider News 
CSC
Resources Available To NHP Providers
Reminder
 
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NHPNet, the secure provider portal, is your primary resource for simple transactions such as verifying member eligibility, checking on a claims status, and checking on an authorization status. To sign up for NHPNet, Click Here. 
 
For questions that cannot be resolved via NHPNet such as complex claims related issues, send us an e-mail at providerservice@nhp.org.

To reduce the overall time your office staff spends on the phone each day, this e-mail box line is monitored by a dedicated team of Provider Service representatives to always ensure you get a timely response. 
EOP

Suppress Your Paper Explanation of Payments Today!  

Reminder

 

All providers have on-demand access to their explanation of payments (EOPs) via NHPNet. To stop receiving paper EOPs sent to your office, follow these 2 easy steps:

1) To access the EOP Suppression request form, click on one of the links found via NHPNet:

                                                                         
                Under the E-Business tab                      -or-                         In the Explanation of Payment box


2) Select the "Explanation of Payment Suppression" checkbox and press next to confirm your selection.



While registering for EOP suppression, you can also sign up for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) capabilities. If you have any questions during EFT registration, please contact Alegeus at 877-389-1160 or ProviderNet@Alegeus.com. For questions related to ERA registration or EOP suppression, please contact the NHP Provider Service Team at 855-444-4647.

Not Registered for NHPNet? Click Here

Pharmacy

Pharmacy Updates 

Update

 

Opioid Analgesics
Opioid overuse, misuse, and abuse continue to be a public health concern both nationwide and statewide. In an effort to align our clinical pharmacy program with recommendations from the Centers for Medicare and Medicaid Services and with changes being implemented by payers across the state, including MassHealth, NHP will implement quantity and dose limits for both long and short-acting opioids effective May 1, 2014. More details to follow.

Xolair
Effective May 1, 2014, Xolair must be obtained from BriovaRx, NHP's preferred specialty pharmacy vendor. If you have a NHP member on Xolair, you and your patient will receive notifications of this change within the next few weeks.

ICD10

ICD-10 Testing  

Update

 

NHP is an active member of the Massachusetts Health Data Consortium (MHDC) and is participating in their ICD-10 implementation project. The MHDC is working towards a statewide collaborative approach to ICD-10 implementation with over 70 participating organizations (consisting of payers, providers, and trading partners). NHP is also conducting testing directly with providers who are not involved with the MHDC. For additional information, please refer to our ICD-10 FAQ by Clicking Here.

Economic

How To Recognize Signs Of Economic Abuse In A Relationship 

By Dr. Paul Mendis, Chief Medical Officer  

 

Has your partner ever left you out of a major financial decision, forged your signature on important documents, or created debt in your name? If so, you may be one of the millions of Americans who experience economic abuse.

Economic abuse is a serious, and often overlooked, form of domestic violence, which can leave a partner completely dependent on an abuser to supply basic material needs for economic security. An abuser will control a partner's finances and prevent him or her from accessing resources, maintaining control of earnings, and gaining financial independence. The abuser may also interfere with a significant other's work performance or prevent education, job training, and the ability to find and keep a job.

Typically, economic abuse goes hand-in-hand with domestic violence, which is experienced by one in four women in their lifetime, constituting a significant public health issue. We usually associate domestic violence with physical or verbal abuse, but economic abuse is just as significant and can have long-lasting and devastating effects. The National Coalition Against Domestic Violence reports that over 1.75 million workdays-or $3 to $5 billion-are lost each year as a result of absenteeism, decreased productivity, and health and safety costs associated with domestic violence.

Economic abuse can also affect a victim's access to health care and medicine. A victim of abuse may resist leaving an abusive partner because his or her children are dependent on that partner's health insurance. Or, the victim may avoid medical care altogether because transportation options have been withheld or limited, or because he or she cannot pay for co-payments while a partner controls the finances.

It is important to remember that economic abuse, like other forms of domestic violence, can happen to anyone, regardless of age, race, gender, sexual orientation, marital status, or income. Controlling someone's finances and opportunities for advancement limit the resources that are needed when a partner decides to leave. Victims of economic abuse often feel forced to choose between staying in an abusive relationship or face economic hardship and possibly poverty and homelessness.

These far-reaching consequences signify the need to do more to address domestic violence. If you or a loved one might be experiencing economic abuse, there are steps you can take and resources you can access to get help.

The key steps for achieving financial independence include:
  • Taking a financial inventory;
  • Obtaining a copy of your credit report to see if anything looks suspicious or unexpected;
  • Keeping personal financial information in a safe place (i.e. at a friend's);
  • Keeping copies of home or car keys in your wallet along with extra money and emergency phone numbers;
  • Determining what it would cost to live on your own and start setting aside money in a safe space (even if it's a few dollars at a time); and
  • Considering public assistance programs such as cash assistance known as Temporary Assistance for Needy Families or TANF or unemployment benefits, which can be accessed at your local Department of Health and Human Services. 
Evidence shows that addressing domestic violence in a health care setting can have a positive impact on health and wellness. Abused women of all backgrounds repeatedly use medical services for treatment of injuries and chronic conditions resulting from violent relationships.

At Neighborhood Health Plan (NHP), we work at the intersection of health care and the communities we serve by partnering with community health centers (CHCs) and local organizations. Through the NHP Domestic Violence Initiative, we are strengthening awareness and resources, including working with CHCs to provide trainings and implement screening policies; and creating deeper community collaborations and gathering data on community needs.

Remember, if you or someone you know is in an abusive relationship, there are resources to help. The multilingual Massachusetts SafeLink Hotline is available at: 1-877-785-2020, TTY: 1-877-521-2601. If you are in immediate danger, dial 911.

Paul Mendis, MD is the chief medical officer for Neighborhood Health Plan. A graduate of Princeton University and Harvard Medical School, Dr. Mendis is board-certified in internal medicine and has practiced primary care for more than 20 years in urban health center environments.This article was originally posted on Boston.com on February 10, 2014. 

References:

National Coalition Against Domestic Violence, "Domestic Violence Fact Sheet"

National Coalition Against Domestic Violence, "Economic Abuse Fact Sheet"

Claims

1500 Paper Claims Form 

Claims  

 

As previously communicated, NHP now accepts the updated 1500 paper claims form that the National Uniform Claim Committee (NUCC) approved. Although NHP strongly encourages the use of electronic claims submissions, we will accept either the current or revised 1500 form until 3/31/14 for any paper submissions.

Effective 4/1/14, NHP will only accept the revised 1500 form for all paper claims submissions.

Click Here to view the revised form. 

IE7

Discontinuance of Internet Explorer 7 Browser Support

Technology Update  

 

Beginning on April 1, 2014, HealthTrio, LCC will discontinue support of Microsoft's Internet Explorer 7 browser. Providers use HealthTrio to enter authorizations and referrals. For the best compatibility and provider experience, please use a later version of Internet Explorer or another web browser. 


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 
 

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