The Health Partners Plans Provider Manual reflects current policies, procedures and applicable changes to Medical Assistance (Health Partners) and CHIP (KidzPartners) benefit packages.
The manual is posted by each section in PDF format and it can be printed in part or in its entirety. Note: Chapter 7 – Health Partners Essential Benefits Summary is intentionally omitted due to the Pennsylvania Medicaid Expansion decision.
- Frequently Asked Questions
- Member Eligibility & Enrollment
- Health Partners Benefits
- Health Partners Medicare Benefits
- KidzPartners Benefits
- Utilization Management
- Quality Management
- Healthier YOU
- Provider Practice Standards
- Provider Billing & Reimbursement
- Complaints, Grievances and Appeals
- Medicare Compliance Requirements
Provider Manual Updates
Our provider manual is reviewed and updated annually. Updates and addendums can be viewed in our Provider Manual Updates Library.
Your feedback is important to us
If you have any recommendations for the manual or its online presentation, please share them by calling our Provider Helpline at 1-888-991-9023. You can also contact your Network Account Manager.