May 2016
nhp.org/provider
Provider News 
 Sox
NHP Teams Up with the Red Sox Foundation  
  baseball_ball.jpg
NHP is teaming up with the Red Sox Foundation to promote health and wellness among teens in  high-risk and inner city communities in Boston.

NHP is proud to be the first health plan to sponsor the Red Sox Foundation's Reviving Baseball in Inner Cities (RBI) program, which uses team sports to reduce youth violence, inspire academic success, promote healthy choices and develop useful life skills. The Foundation's RBI program and its companion Rookie League support a diverse group of children between the ages of 5 and 18. 

You can learn how NHP is sponsoring the RBI program, which supports our longstanding commitment to engage with and help reduce and eliminate health care disparities in communities most in need, by reading our press release.  
 
PCP 
Primary Care Provider Assignment Changes   
 
In our continuing efforts towards administrative simplification and data integrity, effective June 1, 2016, Primary Care Provider's (PCPs) can only update their NHP patients' PCP assignment via NHPNet. Faxed PCP assignment change requests will no longer be processed. 

Through NHPNet, PCP office staff can reassign their NHP patients to another PCP panel within the same group practice. Starting 6/1/16, the following enhancements will be made to NHPNet:
  • PCPs will be able to reassign members to a closed panel PCP within their group practice.
  • PCPs will be able to add NHP patients to their panel from another PCP panel outside their group practice. To complete this transaction, you will be required to attest to obtaining member consent.
As a reminder, members can update their PCP assignment via the member portal (MyNHP.org) or by calling Customer Service.

wellnewborn
Well Newborn Claim Submissions 
 
When a newborn has been enrolled in NHP coverage and has their own ID number, claims for well newborn care provided in the newborn nursery during the mother's inpatient delivery stay can now be submitted with either the mother's member ID number or with the baby's member ID number. Note: only 1 claim should be submitted for well newborn care.

There is no change to the process for sick newborn claim submissions which must be submitted with the baby's member ID number. The provider payment guideline regarding Newborn Care (Inpatient) will be updated shortly. 
 

  postpartum
Postpartum Resources 
 
Last Fall, you may have received NHP's resource kit with tools to make it easy to schedule postpartum visits. The resource kit included the following materials: If you received this tool kit or would like to request a copy of the tool kit, please complete this quick survey.

You can also directly place an order to have copies of these materials sent right to your office.

electric
Electronically Submit Your Correct Claims  
 
For faster processing times, NHP recommends the electronic submission of corrected claims.
To submit a corrected facility or professional claim electronically:
  • Enter the frequency code (third digit of the bill type for institutional claims; separate code for professional claims) in Loop 2300, CLM05-3 as either "7" (corrected claim), "5" (late charges), or "8" (void or cancel a prior claim).
  • Enter the original claim number in Loop 2300, REF segment with an F8 qualifier. For example, for claim # 12234E01234, enter REF*F8*12234E01234.
As a reminder, paper corrected claim submissions must be typed or computer generated. Submissions with any handwritten information in the required claim fields will not be processed and will be sent back to the provider.
 
  manual
Provider Manual 
 
NHP's Provider Manual is a helpful guide for providers to efficiently and effectively do business with NHP. As previously announced, the Provider Manual has recently been updated. Click Here to view the latest version.  

 
  singlesignin
NHPNet Single Access Login 
 
Did you know NHPNet supports access to multiple provider sites with a single account? Providers who are setup with multiple sites can switch the currently viewed site by selecting the requested site from the drop-down box at the top navigation bar and pressing Go:

 
How to Request Additional Site Access
  1. Select "Your Profile" from the drop-down list when hovering over your name
  2. On the following page, click on the "Site Access" tab
  3. Click on "Request Site Access"
  4. The Request Site Access window will appear:
    1. Enter the name (or partial name) of the site for which you need access
    2. Click Select
    3. Enter the site's Tax ID
    4. Enter the reason(s) for your request
    5. Select yes or no in the drop-down box if you will be a User Administrator for this site.    Note: user administrators must complete and fax back the NHPNet User Administrator Application
  5. Click Submit
  S3005
Perinatal Screening (S3005) Update
 
MassHealth recently announced a delay to the implementation of applying reimbursement for the perinatal screening code S3005. To align with this update, NHP will not reimburse S3005 for MassHealth members, originally scheduled to start on May 1, 2016. Providers should continue to use S3005 to report screenings only.

  beacon
Beacon Launches a New PCP Toolkit 
 
Beacon Health Options, NHP's Behavioral Health Partner, has launched a new PCP toolkit at http://pcptoolkit.beaconhealthoptions.com/ which can assist primary care providers in working to integrate mental health and substance use disorder diagnosis and treatment into their patient care.

  chiro 
Reminder: Chiropractic Benefit Update for MassHealth Members 
 
Effective June 1, 2016, the MassHealth Chiropractic benefit will be limited to 20 visits per benefit year (October 1 -September 30). Existing authorizations that extend past June 1, 2016, will remain in place. New authorization requests for visits that exceed the 20 visit benefit limitation on or after June 1, 2016 will not be considered.

neuro 
Universal Neuropsychological Assessment Form                
 
The Mass Collaborative recently developed a universal form for neuropsychological assessment prior authorization requests. This form is now available in the Forms section of nhp.org/provider.
Starting May 1, 2016, all requests for neuropsychological assessments with a medical diagnosis must be submitted on this form and faxed to NHP at 617-586-1700.


Thank You! 

 

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