Welcome to the Optum Network!
UPDATED 03/21/22
21st Century Cures Act – Screening/Enrollment
Begin enrollment NOW to avoid claims denials and Network Termination on July 1, 2023
Do you file claims with Rhode Island Medicaid? Keep your billing privileges by completing your state screening and enrollment.
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.
Rhode Island Resources
Optum BH provider training refresher
- Agency Billing
- RI UHC C&S prior auth and notification information
- Rhode Island Medicaid Prior Authorization Approval Notice
- RI Telehealth/Virtual Visits Billing Requirements
- Virtual Visit Attestation Information
- Express Access Network
- Optum Networks Overview
- NPI and Taxonomy requirements on claim submissions information
- RI Provider Appointment Availability
- Optum and NHPRI Escalation Process
- Optum and UHC Community & State Escalation Process
- Provider Express – Key Links
- RI COB Provider Training
- Updating Provider Directory Data – Directory Attestation Guide
- Important Information Related to Claims Payment
- Viewing Provider Remittance Advice
- New Medicare Advantage plans for members in your area
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.
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