Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)
Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) is a Medicaid managed-care plan operating in Rhode Island. For an ASC, what matters isn't the logo. It's how Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) analysis
Tell us where to send it. Our team will prepare an analysis of Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) pays
See how Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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
Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)'s presence spans Rhode Island. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)'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 Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)
- Payer ID
- 05047 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) members are verified before the date of service, through a clearinghouse using payer ID 05047or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) the way it pays.
- What is Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)'s payer ID?
- Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)'s electronic payer ID is 05047. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) through a clearinghouse.
- How do ASCs verify eligibility for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) members?
- Eligibility and benefits for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 05047) or through the payer's provider portal.
- Does Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) require prior authorization for ASC procedures?
- Prior-authorization requirements for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) are set per plan and per procedure. Confirm whether an authorization is required with Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) directly before the date of service.
- What type of payer is Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)?
- Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) is a Medicaid managed-care plan operating in Rhode Island.
- How does Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) paying my ASC below market?
- Put your own Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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.