What is the EIN for Neighborhood Health Plan of Rhode Island?

Simply enter the organization's name (Neighborhood Health Plan of Rhode Island) or EIN (050477052) in the 'Search Term' field.

How do I cancel my neighborhood health plan in RI?

1-855-840-4774 if you have questions or would like help withdrawing your request for coverage during regular operating hours: Mon - Fri 8:00 am-7 pm.

What is the timely filing limit for neighborhood health plan appeal?

Claims must be resubmitted with all appropriate information within one hundred eighty (180) days from the date of service. For date range claim submissions, (i.e., claims that require from / to and/or through dates) 180 days begins at the to / through date.

What is the PO box for the Neighborhood Health Plan of Rhode Island?

Please avoid violating PHI rules by sending only claims for members of Neighborhood Health Plan of Rhode Island to PO Box 28259, Providence, RI 02908-3700.

Is Neighborhood Health Plan of Rhode Island a Medicaid plan?

Neighborhood is one of only two Medicaid Health Plans out of 185 across the country to achieve this rating in 2021 and the only Medicaid Health Plan to do so in Rhode Island.

What is the payer ID for Medicaid in Rhode Island?

Payer Name: Medicaid - Rhode Island Payer ID: MCDRI Professional (CMS 1500)

US Legal Forms
Form Library
More Forms
More Uncategorized Forms
Provider Appeal Request Form - Neighborhood Health Plan Of ...

Get Provider Appeal Request Form - Neighborhood Health Plan Of ...

Q: What is the EIN for Neighborhood Health Plan of Rhode Island?

Simply enter the organization&#039;s name (Neighborhood Health Plan of Rhode Island) or EIN (050477052) in the &#039;Search Term&#039; field.

The new appeal s receipt date will be consistent with the date the corrected form is received by NHP. To ensure a timely response please include the address to be used by NHP when responding if different from what is listed within the Provider Information section of this form. If possible please complete this form electronically and then print to fax or mail. Check applicable reason for Appeal No Authorization including sick newborn Contract/fee schedule payment dispute Other please explain For audit specific appeals please use the designated Provider Audit Appeal Form http //www. Administrative Provider Appeal Form Mail form to Neighborhood Health Plan 253 Summer Street Boston MA 02210-1120 Attn Provider Appeals Department Or fax to Fax 617-772-5511 Appeals submitted with all required information will be processed within 30 calendar days from receipt. When applicable providers are strongly encouraged to include relevant documentation to support the reason for the appeal i.e. evidence of timely filing Explanation of Payment/Remittance Advice authorization request fax transmittal etc. Please do not include medical records with your submission. Upon receipt and review providers are notified by NHP if additional information is required. All fields are required. Incomplete forms will be returned to the sender for review and resubmission to NHP. Administrative Provider Appeal Form Mail form to Neighborhood Health Plan 253 Summer Street Boston MA 02210-1120 Attn Provider Appeals Department Or fax to Fax 617-772-5511 Appeals submitted with all required information will be processed within 30 calendar days from receipt. When applicable providers are strongly encouraged to include relevant documentation to support the reason for the appeal i*e* evidence of timely filing Explanation of Payment/Remittance Advice authorization request fax transmittal etc. Please do not include medical records with your submission* Upon receipt and review providers are notified by NHP if additional information is required* All fields are required* Incomplete forms will be returned to the sender for review and resubmission to NHP. nhp*org/PDFs/Providers/AuditAppealForm*pdf Contracted NHP Provider Yes No Revised December 2010 Provider Information Provider Name Address City State Zip NPI Number Tax ID Number Fax Sender/Contact Information Name Title Telephone Email Address if different from above Member Information NHP Member Name NHP Member ID Claim Information NHP Claim Number s Date s of Service Claim Amount s Is Explanation of Payment EOP enclosed Is additional supporting documentation enclosed Additional Information. Administrative Provider Appeal Form Mail form to Neighborhood Health Plan 253 Summer Street Boston MA 02210-1120 Attn Provider Appeals Department Or fax to Fax 617-772-5511 Appeals submitted with all required information will be processed within 30 calendar days from receipt. When applicable providers are strongly encouraged to include relevant documentation to support the reason for the appeal i*e* evidence of timely filing Explanation of Payment/Remittance Advice authorization request fax transmittal etc.

How It Works

Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save

saxemov rating

★ ★ ★ ★ ★

★ ★ ★ ★

★ ★ ★

★ ★

★

4.8Satisfied

45 votes

How to fill out and sign Submission online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

The days of frightening complex legal and tax forms have ended. With US Legal Forms completing legal documents is anxiety-free. The best editor is right close at hand giving you a wide range of useful instruments for submitting a Provider Appeal Request Form - Neighborhood Health Plan Of .... These guidelines, in addition to the editor will guide you through the whole procedure.

Select the Get Form option to start filling out.
Turn on the Wizard mode in the top toolbar to get extra pieces of advice.
Fill in each fillable field.
Make sure the details you add to the Provider Appeal Request Form - Neighborhood Health Plan Of ... is up-to-date and correct.
Indicate the date to the template with the Date function.
Click on the Sign tool and create an electronic signature. You can find 3 options; typing, drawing, or uploading one.
Make certain every field has been filled in properly.
Select Done in the top right corne to save and send or download the file. There are several ways for receiving the doc. An attachment in an email or through the mail as a hard copy, as an instant download.

We make completing any Provider Appeal Request Form - Neighborhood Health Plan Of ... simpler. Start now!

How to edit Audit: customize forms online

Say goodbye to a traditional paper-based way of completing Audit. Get the form completed and certified in minutes with our professional online editor.

Are you challenged to revise and complete Audit? With a professional editor like ours, you can complete this task in only minutes without the need to print and scan documents over and over again. We provide you with fully customizable and straightforward form templates that will serve as a start and help you complete the necessary document template online.

All forms, automatically, contain fillable fields you can execute once you open the template. Nevertheless, if you need to polish the existing content of the form or add a new one, you can select from various editing and annotation options. Highlight, blackout, and comment on the document; add checkmarks, lines, text boxes, graphics and notes, and comments. Moreover, you can quickly certify the template with a legally-binding signature. The completed form can be shared with others, stored, imported to external apps, or transformed into any popular format.

You’ll never go wrong by using our web-based solution to execute Audit because it's:

Easy to set up and utilize, even for users who haven’t completed the documents electronically before.
Powerful enough to allow for multiple editing needs and form types.
Safe and secure, making your editing experience protected every time.
Available for various devices, making it stress-free to complete the form from just about anywhere.
Capable of generating forms based on ready-drafted templates.
Compatible with numerous file formats: PDF, DOC, DOCX, PPT and JPEG etc.

Don't waste time editing your Audit the old-fashioned way - with pen and paper. Use our feature-rich option instead. It offers you a versatile suite of editing options, built-in eSignature capabilities, and ease of use. The thing that makes it stand out is the team collaboration capabilities - you can work together on documents with anyone, build a well-organized document approval workflow from the ground up, and a lot more. Try our online tool and get the best value for your money!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to Provider Appeal Request Form - Neighborhood Health Plan Of ...

EOP
AuditAppealForm
Transmittal
remittance
Attn
applicable
Providers
electronically
sender
org
timely
submission
audit
Revised
exceeded

If you believe that this page should be taken down, please follow our DMCA take down processhere.

VeriSign secured

#1 Internet-trusted security seal. Ensures that a website is free of malware attacks.
Accredited Business

Guarantees that a business meets BBB accreditation standards in the US and Canada.
TopTen Reviews

Highest customer reviews on one of the most highly-trusted product review platforms.