NeighborHealth
NeighborHealth is a payer organization operating in Massachusetts. For an ASC, what matters isn't the logo. It's how NeighborHealth pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete NeighborHealth analysis
Tell us where to send it. Our team will prepare an analysis of NeighborHealth covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How NeighborHealth pays
See how NeighborHealth reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
NeighborHealth's presence spans Massachusetts. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for NeighborHealth and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive NeighborHealth's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking NeighborHealth up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with NeighborHealth
- Payer ID
- 25849 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to NeighborHealth through a clearinghouse.
- Eligibility verification
- Coverage and benefits for NeighborHealth members are verified before the date of service, through a clearinghouse using payer ID 25849or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with NeighborHealth directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of NeighborHealth the way it pays.
- What is NeighborHealth's payer ID?
- NeighborHealth's electronic payer ID is 25849. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to NeighborHealth through a clearinghouse.
- How do ASCs verify eligibility for NeighborHealth members?
- Eligibility and benefits for NeighborHealth members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 25849) or through the payer's provider portal.
- Does NeighborHealth require prior authorization for ASC procedures?
- Prior-authorization requirements for NeighborHealth are set per plan and per procedure. Confirm whether an authorization is required with NeighborHealth directly before the date of service.
- What type of payer is NeighborHealth?
- NeighborHealth is a payer organization operating in Massachusetts.
- How does NeighborHealth compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where NeighborHealth pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is NeighborHealth paying my ASC below market?
- Put your own NeighborHealth contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.