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Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)

medical

Summary

Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) is a medical payer operating in Rhode Island. Claims route under payer ID 05047, with 4 alternate IDs in use across clearinghouses. Through clearinghouses it supports eligibility checks, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID
05047Also seen as 10630, 2487, 3645, RINHP
Also known as
NHPRI, Neighborhood Health Plan Rhode Island
Service area
RI

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

TransactionEnrollmentTypical setup
Eligibility checks (270/271)Not requiredImmediate
Professional claims (837P)Not requiredImmediate
Institutional claims (837I)Not requiredImmediate
ERA / remittance (835)RequiredSeveral weeks

Common questions

What is the payer ID for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial)?
The payer ID for Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) is 05047. Alternate IDs seen across clearinghouses include 10630, 2487, 3645, RINHP.
Does Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) require ERA enrollment?
Yes. Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
What states does Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) cover?
Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) operates in RI. Coverage can differ by plan and product line, so confirm the specific plan before you file.
What types of coverage does Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) offer?
Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) covers medical.
Can I submit claims to Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) electronically?
Yes. Neighborhood Health Plan of Rhode Island (Medicaid/Commercial) is reachable through clearinghouses for eligibility checks, professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).

Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.