Neighborhood News & Updates

Updated Payment Policies for Dual Plans

Neighborhood Health Plan of Rhode Island (Neighborhood) has announced updates to its existing payment policies to better support its dual-eligible plan offerings, including INTEGRITY for Duals (HMO D-SNP) and Dual CONNECT (HMO D-SNP).

These updates ensure that payment guidelines are aligned across applicable lines of business and provide clearer direction for providers working within these plans.

Policies Now Available

The following payment policies have been updated and are now accessible on the Neighborhood website:

• Autism and Developmental Services
• Chiropractic Services
• Clinical Trials
• Complementary and Alternative Medicine (CAM)
• Coordination of Benefits
• Diabetes Prevention Program
• Drug Testing
• Extended Family Planning
• Hearing Aid Services
• Physical and Occupational Therapy
• Speech Therapy

What’s Coming Next

Neighborhood has indicated that additional payment policies are currently under review and will be released in the coming weeks as they are finalized.

Billing Guidance in the Interim

For any services where an updated payment policy has not yet been published, providers should continue to bill Neighborhood following standard Medicare billing practices.

Helpful Resources

• Neighborhood Health Plan of Rhode Island – Payment Policies
  https://www.nhpri.org/providers/payment-policies/
• INTEGRITY for Duals (HMO D-SNP) Overview
  https://www.nhpri.org/members/medicare/integrity/
• Dual CONNECT (HMO D-SNP) Overview
  https://www.nhpri.org/members/medicare/dual-connect/
• Medicare Billing Guidelines (CMS)
  https://www.cms.gov/medicare/billing