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Providers
Tools and Resources

Find additional information by logging into the provider portal.

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

Provider Manual

Access the provider manual for information on policies and procedures

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Provider Directory

View the provider directory

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Formularies

Review online formularies

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Policy Bulletin Library

Learn more about medical, claim payment reimbursement and drug positions

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Form and Supply Requests

Download administrative forms

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Training and Education

Browse training and education opportunities for providers

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Additional Resources

Provider Quick Reference Guide

Our provider Quick Reference Guide is a one-stop shop for important information and phone numbers.

Download the PDF

Updated March 2025

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.

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Frequently Asked Questions

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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