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Providers
Join Our Provider Network

Thank you for your interest in joining our growing provider network!

 

To submit a request for consideration, please fill out the form below. We will review your request and a representative will contact you regarding next steps. This is not an official registration.

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Preferred Language

*If you are submitting this form as a Medicaid provider, you must have a valid PA Medicaid PROMISe ID. If you are submitting this form as a Medicare provider, you must have a valid Federal Medicare number and not be listed on the Medicare Opt-Out report.

Contact Specific Departments
Member Relations

1-833-422-4690 (TTY 1-877-454-8477)
We are available from 8 a.m. – 8 p.m., seven days a week, from October – March 31 and 8 a.m. – 8 p.m., Monday through Friday, from April 1 – September 30.

Corporate Office

215-849-9606
Monday – Friday, 8:30 a.m. – 4:30 p.m.

1101 Market Street, Suite 3000
Philadelphia, PA 19107

Provider Services

For health care professionals:
1-888-991-9023 or 215-991-4350

Pharmacy Services

For health care professionals:
1-866-841-7659 or 215-991-4300

Credentialing

We use the Council for Affordable Quality Healthcare (CAQH) system for credentialing and recredentialing our providers. Visit the CAQH website to register or log in to the CAQH Universal Provider Datasource to ensure that your application is up to date.

Provider organizations who are already contracted by Jefferson Health Plans and/or Health Partners Plans and need to have a new individual provider credentialed must submit a Provider Data Collection Form. We make every attempt to complete each application within 60 days of receipt of a complete application.

If you have questions about this process, please email our credentialing department at credentialing@jeffersonhealthplans.com.

Recredentialing

Individual providers are recredentialed within 36 months or less. Providers are notified four months prior to their recredentialing due date. Use this online form to submit a recredentialing request. 

Additional Credentialing Resources
Frequently Asked Questions

Provider groups that would like to link an actively participating provider should submit a linkage request via email on company letterhead to datavalidation@jeffersonhealthplans.com. Your signed linkage request letter on company letterhead must include the following:

  • Group name
  • Group NPI
  • Individual NPI 
  • Tax ID
  • Effective date of the linkage
  • Complete address (including phone/fax number)
  • Contact information

Participating provider groups that need to update their contact information (e.g., name, address, phone number, etc.) should submit the information change on company letterhead to datavalidation@jeffersonhealthplans.com. A Jefferson Health Plans representative will contact you if additional information is required.

Providers should review their provider contract and review the contract termination requirements and ensure notification to Jefferson Health Plans meets requirements outlined in provider’s contract. Providers should submit termination notice to datavalidation@jeffersonhealthplans.com and contracting@jeffersonhealthplans.com.

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