Neighborhood News
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Announcements
- Changes to Provider Appeals Submission Process
- NaviNet’s New Feature: Patient List
- Prior Authorization Requirements Removed for Chiropractic Services
- Supplemental Benefits for Neighborhood Integrity (Medicare-Medicaid Plan) Members
- What is a Certified Community Behavioral Health Clinic?
New Documentation Requirements
- New Documentation Requirements for Adult Day Services
- New Documentation Requirements for Pediatric Health Home Services; Billing Reminder
Payment Policies
Pharmacy
- Cost Saver Program for Commercial Members
- How to Bill 340B Appropriately
- INTEGRITY (MMP) PrEP Coverage
- Medicaid and Commercial Limited Specialty Pharmacy Network
- Opioid Prescribing and Alternative Therapies for Neighborhood INTEGRITY Members
- Pharmacy Benefit Medicaid Drug Rebate Program (MDRP)
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
- Reminder: Specialty Medication Prior Authorization Criteria
- Upcoming Medicaid Pharmacy Benefit Changes
Monthly Pharmacy Benefit Changes: On a monthly basis, Neighborhood places a list of formulary changes on its website for each line of business. For more information, please visit the Pharmacy Provider Resources webpage.
Quality Improvement
- Annual Testing and Monitoring for Patients with Schizophrenia
- Appropriate Antibiotic Use
- Coding for Eye Exams for Patients with Diabetes
- Enhancing Adult Immunization Rates
- Helping Your Patients to Better Understand the Flu Shot
- Human Papillomavirus (HPV): How to Increase Vaccination Rates
- National Lead Poisoning Prevention Week: You Can Help
- Neighborhood Membership Language Profile 2024
- Statin Therapy for Patients with Diabetes
- The Importance of Well Child Visits
Reminders
- Care Plan Signature Requirement
- How Your Patients Can Keep Their Medicaid Benefits After the “Unwinding” Process
- Post-Service Prior Authorizations No Longer Accepted for MMP Line of Business
- Process for Appealing Evolent Decisions
- Requesting a PCP Change for a Member
- Use of Corrected/Voided Claim Request Form
Risk Adjustment
The News and Updates section of the Neighborhood website is used to share important news and information including notifications on payment policies, operational issues, and more.