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Proveedores
Herramientas y recursos

Find additional information by logging into the provider portal.

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If you need additional information or resources, please see below:

Manual de proveedores

Access the provider manual for information on policies and procedures

Directorio de proveedores

View the provider directory

Formularios

Review online formularies

Biblioteca de boletines de políticas

Learn more about medical, claim payment reimbursement and drug positions

Solicitudes de suministros y formularios

Download administrative forms

Educación y capacitación

Browse training and education opportunities for providers

Recursos adicionales

Provider Quick Reference Guide

Our provider quick reference guide is a one-stop shop for important information and phone numbers.

Fraud, Waste and Abuse Information and Hotline

Jefferson Health Plans and Health Partners Plans prohibit all illegal and/or unethical conduct by members, employees and providers. Our Special Investigations Unit proactively addresses questionable activity and investigates referrals of illegal or unethical conduct.

Preguntas frecuentes

Additional patient tools and resources can be found in our provider manual.

To access the consent form for a provider to file a grievance for a member, click here. To access the consent form for a provider to request a fair hearing on behalf of a member, click here.

Jefferson Health Plans medical directors are available to discuss utilization review decisions with peers by calling 215-967-4570.

Our current access and appointment standards for participating providers can be found in our provider manual.

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