Administrative
- Appointment of Representative (AOR) Form
- ID Card Education Flyer (English) ID Card Education Flyer (Spanish)
- Interpreter Request E-Form
- Member Education Request Form
- PCP Change e-form
Claims
- Claim Adjustments
- Claim Form Finder
- Claim Reconsideration Request E-Form
- Corrected (Replacement)/Voided Claim Request Form
- Duplicate Remittance Advice (RA) Statement Application
- Electronic Payment and Remittance Advice Application – Please email completed form to eftproviders@nhpri.org
- Electronic Reconsideration Request E-Form Instructions
- Provider Administrative Appeal E-Form
- Provider Clinical Appeal E-Form
Clinical
Claim Form Finder
Not sure what form to use? Neighborhood’s Claim Form Finder identifies the most common reasons a claim modification is requested, as well as, the accompanying form or process.