New Claim Reconsideration Process, Effective April 1, 2017
Neighborhood is pleased to announce a new process for requesting claim reconsiderations! In addition to US mail, providers may also submit requests via fax to (401) 709-7009, or by secure e-mail to Reconsideration@nhpri.org.
Claim Submission Reminder
Neighborhood uses technology to scan paper forms and eliminate keystroke errors. All new and corrected claims must therefore be submitted on original (not photocopied) print versions of the industry standard CMS-1500 and CMS-1450 (UB-04) forms, as they are printed in special optical character recognition (OCR)-scannable red ink.
Claim forms must not contain any handwritten elements, stamps, correction fluid, or staples.
As an alternative to contacting our call center for claim status, please use NaviNet as a first source of information. NaviNet is available when needed- 24 hours per day, seven days a week, and is current through the previous business day.
Please remember to use the most current request forms available on our website. Provider request forms are available in the Claim Forms section of the Provider Manual Forms menu on the Neighborhood website. The Corrected Claim, Reconsideration, Adjustment, and Appeal request forms are writeable, so they can be typed online, then printed and submitted to Neighborhood. Outdated forms will be returned to the sender for correction.
Neighborhood’s policy on Non-Covered Services has been updated and now breaks out services by plan type (Exchange, Medicaid, and Medicare-Medicaid/MMP).