Neighborhood News
Each article below is hyperlinked to a pdf/printable version of the publication. If you would like to receive this newsletter via email, please click here to register and Neighborhood News will be delivered straight to your inbox. Registering your email for Neighborhood News will ensure you receive critical news and information on matters such as new initiatives, policy changes, and much more.
Action Required
Announcements
- New SNF and Rehab Authorization Request E-Form Now Available
- Neighborhood Postpones Transition of Claim Processing for Commercial Line of Business
- Notice of Electronic Claim Submission Requirement
- Radiology Services Appeal Process Change
Reminders
- Commercial Open Enrollment
- Compliance Reminder for Nursing Facilities
- Medicaid Redeterminations: Help Your Patients Keep Their Coverage
Quality Improvement
- Appropriate Antibiotic Use
- HEDIS® Plan All-Cause Re-Admissions (PCR) Measure Guide
- National Lead Poisoning Prevention Week – You Can Help!
- Statin Therapy for Patients with Diabetes
- Well Child Visits
Payment Policy Updates
- New and Updated Payment Policies
- Update to Physical, Occupational, and Speech Therapy Limit for INTEGRITY Members
Behavioral Health
Claims
Medical Management
Benefits
Risk Adjustment
Utilization Management
Pharmacy
- Electronic Prior Authorization for the Pharmacy Benefit
- How to Bill 340B Appropriately
- Medicaid and Commercial Limited Specialty Pharmacy Network
- Medical Benefit Prior Authorization Submission
- Opioid Prescribing and Alternative Therapies for Neighborhood INTEGRITY Members
- Pharmacy Benefit Medicaid Drug Rebate Program
- Prescription Drug Coverage in Assisted Living and Long-Term Care Facilities
- Reminder: Specialty Medication Prior Authorization Criteria
- RSV Prevention Update
- Upcoming Medicaid Pharmacy Benefit Change
- Upcoming Pharmacy Benefit Changes for Inhaler and Insulin Products
- Upcoming Pharmacy Medical Benefit Preferred Therapy 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.