The UnitedHealthcare Neighborhood Health Partnership plans are now being offered
to fully insured commercial customers in the following counties. If you are a provider in these counties please refer to the NHP Quick Reference Grids to assist you in managing the products.

Orange, Seminole, Osceola, Flagler, Lake, Volusia - NHP Quick Reference Grid
Hillsborough, Pasco, Pinellas, Sarasota, Polk, Hernando, Lee - NHP Quick Reference Grid

Transplant Services Request

To help facilitate the Transplant process, effective 7/1/2012 all requests for Transplant Services for Neighborhood Health Partnership will be made to OptumHealth. You may initiate a pre-certification request through OptumHealth by calling (888)936-7246 or by fax to (855)250-8157.

CareCore Pre-Certifications

Injectable Chemotherapy - Effective May 17, 2014, UnitedHealthcare will implement a new Injectable Chemotherapy Prior Authorization Program in Florida. This is a new requirement for UnitedHealthcare members and a change in process for Neighborhood Health Partnership members.

  • Prior authorization for outpatient injectable chemotherapy is required for the treatment of cancer.
  • Pre-Certification forms submitted to Neighborhood Health Partnership will no longer be accepted.
  • Prior authorization request must be submitted on CareCore Nationalís website: medicaloncologyauthorizations.com.
  • We request that all prior authorizations be completed online. On May 1, 2014, site registration begins and requests for injectable chemotherapy prior authorization can be accepted. If you are experiencing internet connection problems or have a question you may call 855-252-1116 Monday through Friday from 7 a.m. to 7 p.m. (EST).
  • View the attached documentation for detailed information and to register for a WebEx training session.

Related Links


Radiology/Cardiology/Nuclear Imaging - Contact CareCore National, (CCN) for Pre-Certification of the following Radiology/Cardiology/Nuclear Imaging Services listed below. Pre-Certifications are required for studies rendered in a physicianís office or in a hospital outpatient setting:

  • CT Scans
  • MRI/MRA
  • PET Scans
  • Echo Stress Tests
  • Nuclear Medicine
  • Nuclear Cardiology

Outpatient Echocardiogram - Contact CareCore National (CCN) for Pre-certification of Outpatient Echocardiogram.

Cardiology - Contact CareCore National (CCN) for Pre-certification of the following cardiology services described below.

  • Diagnostic Cardiac Catheterization performed in any place of service except inpatient hospital.
  • Electrophysiology Implants performed in any place of service, even if an inpatient authorization is in place.

CareCore Pre-Certification Line:
(866)242-9546 Mon-Fri 7am-7pm EST

CareCore Website:
www.carecorenational.com

Please refer to the updated Protocol III for a listing of all services requiring Pre-Certification.

View/print the CCN/NHP Imaging Quick Reference Guide.
View/print the CCN/NHP Cardiology Quick Reference Guide.
View/print the NHP Cardiology Pre-Certification Table and Substitution Table.

Advocare Health Alliance

For Durable Medical Equipment, Home Health, Home Infusion, and Respiratory Services, please contact Advocare Health Alliance, formerly known as Pharmed Health Alliance.

Advocare Health Alliance Customer Services Department
In Miami-Dade County: (305)728-2747
Outside Miami-Dade County: (866)374-4326

Hours are: Monday to Friday, 8:30am - 7:00pm
                    Saturday, 8:30am - 5:30pm

United Behavioral Health (UBH)

Neighborhood Health Partnership (NHP) is committed to providing our members with the finest quality health care. Effective 11/1/2006,United Behavioral Health (UBH) will manage the mental health and substance abuse treatment for all our members.

This administrative change will affect how mental health and substance abuse benefits are accessed. Effective 11/1/2006 all affected members must be referred to UBH to obtain referral/authorization formental health and substance abuse care. You or the member may contact UBH directly at (800)817-4705 to obtain a referral or an authorization. Member benefits are not impacted by this change.

United Behavioral Health has established a network of providers throughout the South Florida area. This network consists of professionals from a variety of disciplines, including psychiatry, psychology, psychiatric nursing, clinical social work and substance abuse.

If you have any questions, please do not hesitate to contact Neighborhood Health Partnership at (877)972-8845 or UBH at (800)817-4705. Effective 11/1/2006 crisis intervention and emergency care are available 24 hours a day, 7 days a week through UBH’s toll-free number.