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Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)

Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)

This page contains information you can use to exchange healthcare transactions with Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) using Stedi.
Use any of the following payer IDs to send transactions to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) using Stedi APIs or SFTP. Read the docs
Primary Payer ID
05047
Stedi Payer ID
LEXAK
Payer ID aliases
05047, 10630, 2487, 3645, RINHP
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 (Medicaid/Commercial) 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 (Medicaid/Commercial).
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 (Medicaid/Commercial) 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 (Medicaid/Commercial) and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 (Medicaid/Commercial) to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 (Medicaid/Commercial).
Get started
Use Stedi's APIs to get fast and reliable connectivity to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) 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 (Medicaid/Commercial) 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 Rhode Island
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