Welcome Rhode Island Behavioral Health Providers
21st Century Cures Act Update (August, 2024)
Medicaid managed care network providers, regardless of specialty, are required to be screened by and enrolled with the State of RI Medicaid program. If a provider has not been screened and enrolled as a Rhode Island Medicaid Provider, all claims/encounters may be denied.
If you receive communication to enroll with RI Medicaid from multiple managed care plans, you only need to submit one application.The application for enrollment/screening can be accessed directly at EOHHS Provider Enrollment Medicaid Screening Application
If you have additional questions or concerns that are not answered by the provider enrollment user guide or for assistance with the enrollment application or to request a user guide, please email Rhode Island Provider Services.
The EOHHS Gainwell customer service help desk phone numbers are:
1-401-784-8100 and 1-800-964-6211 (toll free)
NOTE: Once you are screened and approved by Gainwell, you must request the Medicaid network be added to your profile from each MCO.
For Optum, please email your request that the Medicaid network be added to your profile and provide a copy of your approval letter from Gainwell.
Rhode Island Resources
Network Manual
Standard Clinical Criteria
Optum Behavioral Health Providers Refresher Orientation
Rhode Island Provider Training Session Q&A
Rhode Island DEA Training Requirements
BP Guidelines
Coordination of Care (COC)
COC Flyer 
COC Checklist
- Agency Billing
- RI Telehealth Guidance
- Facility IOP Pre-auth Updates
- Express Access Network
- Important Information Related to Claims Payment
- New Medicare Advantage plans for members in your area
- NHPRI Commercial Member ID Change
- NPI and Taxonomy requirements on claim submissions information
- Provider Express – Key Links
- Rhode Island Medicaid Prior Authorization Approval Notice
- RI COB Provider Training
- RI Provider Appointment Availability
- RI UHC C&S prior auth and notification information
- Optum Networks Overview
- Optum and NHPRI Escalation Process
- Optum and UHC Community & State Escalation Process
- Updating Provider Directory Data – Directory Attestation Guide
- Viewing Provider Remittance Advice
- Virtual Visit Attestation Information
Additional information and forms are available, including psych/neuropsych testing guidelines, credentialing plans, and Disability Solutions Manual, on the Provider Express Guidelines/Policies & Manuals and Optum Forms pages.
Neighborhood Health Plan of Rhode Island
We are providing links to support required training for providers serving Neighborhood Health Plan of Rhode Island (NHP of RI) INTEGRITY members.
Click here to learn about training and attestation requirements and to access links to training provided by NHP of RI.
After completing the trainings, you will be asked to attest to having completed those and, at that time, will also be asked to attest to information related to these topics:
- Neighborhood Policies and Procedures
- Provider Rights and Responsibilities
- ADA Compliance, Accessibility and Accommodations
- Cultural Competency Training
- INTEGRITY (Medicare-Medicaid Plan) Training
If you have questions regarding NHP of Rhode Island directives related to COVID-19, please contact your Provider Relations Advocate.