Thank you for being a valued Jefferson Health Plans provider. Please be advised of the addition of a payor ID for the electronic submission of Medicare PPO claims, as well as the mailing address for paper claims submissions. This will only apply to Jefferson Health Plans Medicare PPO products; claims submission instructions will remain the same for all other Jefferson Health Plans’ products. The Jefferson Health Plans Individual and Family Plans products, effective 1/1/2024, will also be included with all other Jefferson Health Plans’ products.

Please note, Jefferson Health Plans recommends electronic claims submissions.

WHAT IS CHANGING

• ELECTRONIC PAYOR ID for Medicare PPO:RP099
• PAPER CLAIMS MAILING ADDRESS for Medicare PPO:

Jefferson Health Plans
PO Box 981735
El Paso, TX 79998-1637

WHAT REMAINS UNCHANGED

• ELECTRONIC PAYOR ID for ALL other products (Medicaid, CHIP, Medicare HMO/DSNP, Exchange effective 1/1/2024): 80142
• PAPER CLAIMS MAILING ADDRESS for ALL other products (Medicaid, CHIP, Medicare HMO/DSNP, Exchange effective 1/1/2024): 

Jefferson Health Plans
PO Box 981744
El Paso, TX 79998-1744

WHAT’S NEXT?

Starting on 10/14/2023, providers MUST update billing systems/software either through Change Healthcare or your clearinghouse to ensure claims are submitted appropriately to prevent delays in claims’ payments. This may be done by contacting EDI Support at EDI@jeffersonhealthplans.com. Please also reference the EDI section of the Jefferson Health Plans website at HPPlans.com/claims. Jefferson Health Plans will not be accepting Medicare PPO or Individual and Family Plan (ACA) claims submissions prior to 1/1/2024.

If you have any questions, please contact the Provider Services Helpline at 1-888-991-9023 from Monday-Friday 9:00a.m. to 5:30p.m.