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Neighborhood Health Plan of Rhode Island (INTEGRITY)

Neighborhood Health Plan of Rhode Island (INTEGRITY)

This page contains information you can use to exchange healthcare transactions with Neighborhood Health Plan of Rhode Island (INTEGRITY) using Stedi.
Use any of the following payer IDs to send transactions to Neighborhood Health Plan of Rhode Island (INTEGRITY) using Stedi APIs or SFTP. Read the docs
Primary Payer ID
96240
Stedi Payer ID
EKMFL
Payer ID aliases
7171, 8612, 96240
Coverage types
Medical
Operating states
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY
Covered
Not covered

Supported transactions

Use Stedi to exchange the following transactions with Neighborhood Health Plan of Rhode Island (INTEGRITY) using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Neighborhood Health Plan of Rhode Island (INTEGRITY).
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Neighborhood Health Plan of Rhode Island (INTEGRITY) to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Not supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to Neighborhood Health Plan of Rhode Island (INTEGRITY) in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Neighborhood Health Plan of Rhode Island (INTEGRITY) and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Neighborhood Health Plan of Rhode Island (INTEGRITY) and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Neighborhood Health Plan of Rhode Island (INTEGRITY) to review full payment details.
Enrollment process type
One-click
Activation timeframe
-
Not supported

Dental claims

(837D)
Submit dental claims to Neighborhood Health Plan of Rhode Island (INTEGRITY) and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Neighborhood Health Plan of Rhode Island (INTEGRITY).
Get started
Use Stedi's APIs to get fast and reliable connectivity to Neighborhood Health Plan of Rhode Island (INTEGRITY) and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Neighborhood Health Plan of Rhode Island (INTEGRITY) today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • NHPRI
  • Neighborhood Health Plan of Rhode Island (Medicare-Medicaid Plan)
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