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Provider News


Change Healthcare Outage

On 2/21/24, Jefferson Health Plans was alerted by Change Healthcare about a network outage that is disrupting Change Healthcare’s ability to deliver services. This impacts providers who use Change Healthcare to send member eligibility verifications, …

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PCMH Specialist 7-Day Follow-up

As a requirement of the DHS Patient-Centered Medical Home (PCMH) program, patients admitted with an ambulatory sensitive condition must be seen by the primary care PCMH provider or specialist provider within seven days of discharge from the hospita…

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2024 Medicare Member Wellness Rewards

Jefferson Health Plans will continue to offer Wellness Rewards, our Medicare rewards program, to all Medicare members in 2024. Wellness Rewards incentivizes Medicare members to complete specific health-related activities to earn rewards dollars on a …

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2024 MQCP Manual

Thank you for being a Jefferson Health Plans participating provider and for your continued participation in our Maternity Quality Care Plus (MQCP) program. MQCP is designed to recognize and reward your practice’s performance in delivering high-qualit…

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2024 Individuals and Families Resources

We are pleased to announce the live recording and presentation for the 2024 Individuals and Families OEP webinars held in October 2023 are now published to the provider page of our website, in addition to a self-led eLearning course. As a reminder, …

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Blood Pressure Cuff Guidelines

Effective immediately, we have simplified ordering a blood pressure cuff for our Medicare, Medicaid, CHIP* and Individual and Families (Exchange) lines of business. We encourage you to provide guidance to your patients on the proper use of the blood…

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Maternal Transthoracic Echocardiograms

Thank you for being a valued participating provider. We are writing to inform you that effective February 1, 2024, prior authorization for Maternal Transthoracic Echocardiograms (CPT 93306) will no longer be required when accompanied by a pregnancy d…

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Expansion of CHIP Program Offering

Thank you for being a valued provider. We are excited to announce that we are expanding KidzPartners, our Children’s Health Insurance Program (CHIP). KidzPartners is now offered in all 67 counties across the Commonwealth of Pennsylvania. Jefferson H…

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Billing/Regulatory guidance for Hospice providers

Thank you for being a Jefferson Health Plans’ participating provider. In preparation for upcoming provider monitoring that Jefferson Health Plans’ Special Investigation Unit will performing, we would like to make you aware of some recent findings of …

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