Neighborhood Health Plan of Rhode Island will no longer require prior authorization for in-network services

Starting Jan. 1, 2025, you’ll no longer need to obtain prior and concurrent authorization for in-network covered services for members covered by Neighborhood Health Plan of Rhode Island (NHPRI). This change applies to all of NHPRI’s lines of business, including:

• Medicaid
• Commercial
• INTEGRITY (Medicare-Medicaid Plan)

The streamlined process creates more efficiency for you so you can better focus on what’s important – providing care to your clients.

Prior authorization will be required for other insurance carriers supported by Optum, so please keep that in mind as you plan your services.

It’s easy to verify prior authorization requirements using the new Neighborhood Prior Authorization Search Tool on the NHPRI website. Simply enter the procedure/service code in question and select the member’s line of business to determine if prior authorization from Neighborhood is required.

Questions?

If you have questions, you may reach out to the Optum Behavioral Health Provider Service Line at 1-877-614-0484.