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.

eviCore Pre-Certifications

Injectable Chemotherapy - Contact eviCore healthcare for prior authorization for outpatient injectable chemotherapy for the treatment of cancer.

  • Pre-Certification forms submitted to Neighborhood Health Partnership will no longer be accepted.
  • To complete an injectable chemotherapy prior authorization request, you will need to log into UnitedHealthcareOnline.com Then go to: Notifications/Prior Authorizations > Oncology Authorization Submission & Status.
  • All prior authorizations need to be completed online. If you are experiencing internet connection problems or have a question you may call 866-889-8054 from 7am to 7pm, local time, Monday-Friday.
  • Neighborhood Health Partnership does require prior authorization for certain supportive care drugs administered in an outpatient setting as well as the chemotherapy administrative codes and laboratory services. For this program, if the supportive care drugs (this would include the drugs used to treat anemia, neutropenia, anti-emetics, etc.) will be given during the same time period of an injectable chemotherapy regimen that has been prior authorized, no additional authorizations are required for the supportive care drugs. Additionally, no additional authorizations are required for chemotherapy administrative codes, laboratory services administered in the office, oncology office visits, iron infusions and/or anti-metics.
  • Neighborhood Health Partnership does require prior authorization for blood and blood products and these services are NOT included in the chemotherapy prior authorization.

Resources:


Radiology / Imaging - Contact eviCore healthcare for Pre-Certification of the following Radiology/ Imaging Services listed below. Pre-Certifications are required for studies rendered in a physician’s office or in a hospital outpatient setting:

  • CT Scans
  • MRI/MRA
  • PET Scans
  • Nuclear Medicine
  • Nuclear Cardiology

Cardiology - Contact eviCore healthcare for Pre-certification of the following cardiology services described below.

  • Diagnostic Cardiac Catheterization - performed in an Outpatient place of service.
  • Electrophysiology Implants - performed in any place of service, even if an inpatient authorization is in place.
  • Echocardiogram - performed in an Outpatient place of service.
  • Stress Echocardiogram - performed in an Outpatient place of service.

Contact Information - Pre-Certification may be obtained or verified by contacting eviCore healthcare in one of the following ways:

For a listing of Radiology services requiring Pre-Certification, view/print the NHP Radiology/Imaging Pre-Certification CPT Code list.
For a listing of Cardiology services requiring Pre-Certification, view/print the NHP Cardiology Pre-Certification CPT Code list and Substitution Table.

Alternate Contracted National Providers –


Durable Medical Equipment (DME), Home Health, Home Infusion, Respiratory Services, Insulin Pumps and Supplies and Breast Pumps

  • Durable Medical Equipment/Respiratory & Commodity Services (oxygen, CPAP, hospital beds, standard wheelchairs):

  •       Apria 1-855-613-8303, http://www.apria.com/
          Lincare 1-855-236-8277, http://www.lincare.com/
          Rotech 1-877-623-5272, http://www.rotech.com/

  • Medical Supply Providers (disposable supplies, ostomy, urological ,incontinence supplies):

  •       Byram Medical 1-877-902-9726, http://www.byramhealthcare.com/
          Edgepark Medical 1-888-394-5375, http://www.edgepark.com/
          Liberty Medical 1-800-615-0714, http://www.libertymedical.com/
          Medline 1-800-633-5463, http://medline.com/
          McKesson 1- 855-404-6727, http://www.mckesson.com/providers/home-care/mckesson-patient-care-solutions/

  • Home Health Services:

  •       Maxim Healthcare Services 1-855-265-9401, http://www.maximhomecare.com/
          Pediatric Services of America(PSA) 1-800-718-4616, http://www.psahealthcare.com/

  • Home Infusion Services (including enteral):

  •       Bioscrip 1-844-839-5899, http://www.bioscrip.com/
          Accredo 1-855-315-3590, http://www.accredo.com/
          Walgreens Infusion 1-800-683-5252, http://www.walgreenshealth.com/

  • Breast Pumps:

  •       Lincare 1-855-236-8277, http://www.lincare.com/
          Byram Medical 1-877-902-9726, http://www.byramhealthcare.com/
          Edgepark Medical 1-888-394-5375, http://www.edgepark.com/

  • Insulin Pumps and Supplies National Vendors:

  •       Minimed Distribution Group - 800-933-3322, http://www.minimed.com/
          Animas Diabetes Care LLC - 877-937-7867, http://www.animascorp.com/
          Roche Insulin Delivery Systems - 800-280-7801, http://www.accu-checkinsulinpumps.com/
          Smiths Medical MD - 800-826-9703

    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.