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Providers
Tools and Resources

Find additional information by logging into the provider portal.

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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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Shift Care Guide

Our Shift Care Guide outlines shift care services, explains electronic visit verification compliance requirements, highlights billing guidelines, and introduces key resources to help streamline communication

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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.

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Updated December 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.