Provider Manual
The NHP Provider Manual is your resource about how Neighborhood Health Plan works. The following sections of the manual will inform you about NHP's policies and procedures and direct you to the appropriate resources you may need in doing business with Neighborhood Health Plan.
Provider Manual
- Welcome Letter and Corporate Overview
- NHP Member Information
updated September 2008 - Provider Management
updated September 2008 - Quality Programs
updated September 2008 - Clinical Programs
updated September 2008 - CMA Programs
updated September 2008 - Referral Management
updated September 2008
- Utilization Management
updated September 2008
- Billing Guidelines
updated January 2009
Pharmacy
updated September 2008 - Behavioral Health Care
updated September 2008
- Glossary of Terms
The NHP Provider Manual provides convenient web links to many other resources on the NHP website. In addition, the Manual provides links to websites outside www.nhp.org. Please note that NHP does not control the content of links outside of the NHP website, and therefore the information on these external links may not have been reviewed or approved by Neighborhood Health Plan.
The Provider Manual will be updated as needed, and at a minimum on an annual basis. A Provider Manual Update Notice will be posted informing providers of any changes. It is the provider's responsibility to review the on-line Provider Manual for updates to our billing guidelines and other policies and procedures. Neighborhood Health Plan, at its discretion and/or in accordance to contract obligations, will provide advance written notice of changes to our policies and procedures.
NHP Commonwealth Care - Dental Coverage Manual
To access the Doral Dental Coverage Manual, please register at the DoralUSA.com website.