Accessing Your Member Roster Report
Affordable Care Act 
Open enrollment is underway and many residents are required to select new health coverage. Those who get their NHP health insurance through the MA Health Connector or Commonwealth Care can enroll in a new plan on MAhealthconnector.org.
When servicing your NHP patients during this time, please remember to always verify eligibility, benefits, and authorization requirements prior to rendering services.
The Member Roster Report on NHPNet, the secure provider portal, is available for Primary Care Providers (PCPs) to verify current NHP members in your panel. This report gives you access to member information such as product, enrollment date, and listed PCP. Click Here to view instruction on how to access this report.
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HEDIS Data Collection Starts in January
Reminder
The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely-used standardized set of performance measures developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to help consumers compare health plan performance to other plans and to national or regional benchmarks. Each year NHP is required to collect and report HEDIS data from contracted providers. HEDIS data collection will begin in January 2015 and end in May 2015. A member of the NHP HEDIS staff will either schedule an onsite review at your location or ask that you fax or mail the information. Click Here to access the HEDIS FAQ
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Beginning December 1, 2014, All Claims for NHP HMO and MassHealth Members Should be Submitted Electronically, or to a New Mail Address
Claims
Neighborhood Health Plan (NHP) has changed our address for original paper claims submissions. Starting with submissions on or after December 1, 2014, original paper claims for NHP HMO and MassHealth members should be sent to the following new address:
Neighborhood Health Plan PO Box 853908 Richardson, TX 75085-3908 The old mailbox is no longer active. All claims mailed there will be returned. For PPO members, continue to use the claims address listed on the member ID card.
Some Electronic Medical Record systems (EMRs) require inclusion of a payer's physical address. Please ensure your systems are updated accordingly.
For appeals, adjustments, and other correspondence, continue to mail these to 253 Summer St, Boston, MA 02210.
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You Are Invited: Regional Provider Meetings
Provider Education
NHP Provider Relations is hosting a series of regional provider meetings across Massachusetts. Topics include NHP products, the latest on the Affordable Care Act and open enrollment, provider tools/technology, and much more. We thank all our valued providers who have offered meeting space at their facilities for these events. Register today to attend an upcoming session in your area: North Shore Region: Salem
Date: Tuesday December 2, 2014
Time: 10:30-11:30 AM
Location: North Shore Medical Center (Salem Campus) 81 Highland Ave Room: 102B
South Shore Region: Greater New Bedford
Date: Friday December 12, 2014 Time: 12:00-1:00 PM Location: Greater New Bedford Community Health Center 874 Purchase Street New Bedford, MA 02740
Western Region: Holyoke
Date: Friday December 12, 2014
Time: 12:00-1:30 PM
Location: Holyoke Medical Center
575 Beech Street
Auxiliary Conference Center
Holyoke, MA 01040
RSVP: Click Here to RSVP
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Home Health Care Webinar
Provider Education
Join NHP Provider Relations and Clinical in a webinar training on Home Health Care authorizations. In this training, we will review the authorization request process and best practice tips.
Date: Thursday December 11, 2014 Time: 2:30-3:30 PM Location: Webinar
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Authorization Tips and Reminders
Authorizations
Chemotherapy Authorizations
As a reminder, starting December 1, 2014, please select the Chemotherapy option in the Requested Service drop-down menu if you are requesting a Chemotherapy authorization.  Authorization RevisionsDuring the authorization review process, it may be necessary for you to update or request revisions to an existing authorization. To initiate a revision request, log onto NHPNet, the secure provider portal, and click on the Submit or Revise button.  Click Here to access the HealthTrio User Guides for detailed instructions on revision requests.
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Clinical Coverage Criteria
Update
The follo wing Clinical Coverage Criteria is available on nhp.org:
- Acupuncture (effective 12/1/14) - New Clinical Criteria describing medically necessary indicators for acupuncture
Click Here to view all Clinical Coverage Criteria.
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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.
Helen Connaughton
Director of Provider Relations
Neighborhood Health Plan
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