If you recently submitted an application to participate in the Neighborhood Health Providers provider network, once your application has completed the credentialing process, you will receive a letter from us with your provider identification number and effective date. In most cases, your provider number is your license number with 01 on the end. You may also verify your provider identification number by calling our Provider Services Department at 1-800-558-7970. Provider identification numbers are also listed in the NHP Provider Directory available on this website.

Our Provider Service Advocates can be reached the toll free number at 1-800-558-7970. NHP's Provider Services Department is open for business from 9:00 to 5:00 Monday through Friday. At other times, you may access eligibility verification and claims status through NHP's Interactive Voice Response (IVR) system.

The IVR is available 24 hours a day, 7 days a week.

Simply call the toll-free number 1-800-558-7970 and follow the system prompts to use these automated services. For claim status, you will need the member ID, date of service and the tax identification number (TIN) submitted on the claim. For member eligibility verification, you will need the member ID.

You must enter the TIN number submitted on the claim.

If you would like to submit claims electronically, please contact the NHP EDI Coordinator at (631) 881-2470. We will be happy to work with you to coordinate this effort. The NHP WebMD submitter number is 11325.

Yes, NHP requires that all claims be submitted within 90-days from the date of service.

At NHP, the role of the PCP to coordinate ALL patient care. This means that it is the PCP's responsibility to send both NHP and the Referral Specialist are provided the appropriate copies of the Referral Voucher Form. However, it is the Referral Specialist's responsibility to attach a copy of the referral to the claim. REFERRAL SPECIALISTS ARE NOT PERMITTED TO REFER PATIENTS TO OTHER SPECIALISTS FOR FURTHER EVALUATION OR TESTING. IT IS THE RESPONSIBILITY OF THE REFERRAL SPECIALIST TO GO BACK TO THE PATIENT'S PCP AND CONSULT WITH THE PCP REGARDING NECESSARY PATIENT CARE. The PCP will then write necessary referral.

At this time, NHP can not accept Referral Voucher Forms electronically. However, we are currently working hard to enhance our system to be able to accept an electronic referral.

Only Neighborhood Medicare Plan members routinely receive EOBs. For all other products, members receive written notification that include the member appeal rights when services are denied due to lack of medical necessity.