Skip navigation


Eligibility and Claims

Electronic Claims Processing

Would you like to:

  • Decrease administrative costs?
  • Avoid processing delays?
  • Increase your claim acceptance rates?
  • Increase productivity?
  • Receive records of claim receipts?
  • Receive detailed claims status?

You can have speed, convenience and lower administrative costs through Electronic Data Interchange (EDI), or electronic claims processing. Jefferson Health Plans utilizes Smart Data Solutions (SDS) as our clearinghouse.

How to take advantage of this service

  • Contact your billing software vendor and request that your Health Partners, KidzPartners, Jefferson Health Plans Medicare Advantage and Individual and Family Plan claims be submitted through SDS, or
  • Contact SDS directly. All trading agreements would come through them exclusively. You can contact them directly in order to set up a trading platform:

Be sure to include the following information: First name, last name, email, phone, Organization name, Organization NPI, Organization Tax ID, which payer claims will be submitted to:

    • Health Partners (Medicaid) / KidzPartners (CHIP) / Jefferson Health Plans Medicare Advantage HMO / Jefferson Health Plans Individuals and Family: Payer ID# 80142
    • Jefferson Health Plans Medicare PPO: Payer ID# RP099

More information

  • Read our EDI FAQs
  • Submit your question(s) via e-mail using the EDI Inquiry Form
  • Call our Provider Services Helpline at 1-888-991-9023