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Welcome to the Optum Network!

UPDATED 08/01/2023

21st Century Cures Act – Screening/Enrollment

If a provider has not been screened and enrolled as a Rhode Island Medicaid Provider, all claims/encounters with dates of service on or after November 1, 2023, shall not be accepted by Rhode Island Medicaid and will not be considered or count towards future rate setting.

Any Provider who has not completed 21st Century Cures Act enrollment by November 1, 2023 will have their patients assigned to another clinician and will be terminated from the Rhode Island Medicaid program. 

Keep your billing privileges by completing your state screening and enrollment.

Enroll here today

Questions? Read the state’s FAQs here


Optum Network Manual

Clinical Criteria

Best Practice Guidelines

Coordination of Care (COC)

 

Additional information and forms are available, including psych/neuropsych testing guidelines, credentialing plans, and Disability Solutions Manual, on the Provider Express Guidelines/Policies & Manuals and Optum Forms pages.

 

Neighborhood Health Plan of Rhode Island

If you have questions regarding NHP of Rhode Island directives related to COVID-19, please contact your Provider Relations Advocate.

NHP of RI provider attestation training information

We are providing links to support required training for providers serving Neighborhood Health Plan of Rhode Island (NHP of RI) INTEGRITY members. 

Click here to learn about training and attestation requirements and to access links to training provided by NHP of RI. 

After completing the trainings, you will be asked to attest to having completed those and, at that time, will also be asked to attest to information related to these topics:

  • Neighborhood Policies and Procedures
  • Provider Rights and Responsibilities
  • ADA Compliance, Accessibility and Accommodations
  • Cultural Competency Training
  • INTEGRITY (Medicare-Medicaid Plan) Training