Enhanced Eligibility and Benefits Inquiry

Health Plans: 

  • Neighborhood Health Plan of RI

Workflow: 

  • Eligibility and Benefits

When you view eligibility and benefits details for Neighborhood Health Plan of Rhode Island members, you'll notice a new look and feel.

  1. Sign in to NaviNet. On the Health Plans menu, click Neighborhood Health Plan of RI
  2. Under Workflows for this Plan, click Eligibility and Benefits Inquiry. The Patient Search screen appears.
  3. To find the patient, specify the following search criteria:
    • Member ID, or last name, first name (optional), and date of birth. 
    • Date of service. Choose a date up to one year in the past, or up to 30 days in the future.
      To search for a member who is outside their home area, click the Out of Area tab, and specify your search criteria in that tab instead.
  4. Click Search. If more than one patient matches your criteria, choose the patient from the list. The Eligibility and Benefits screen appears for the patient.
  5. View the patient's coverage details. To view coverage for a specific benefit type, click a benefit on the Benefits panel. 

For more details about this workflow, see the Eligibility and Benefits User Guide.

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