Provider Education Self-Management Tools
These online classes were created to keep you informed on a variety of important topics. Click on a course below to start, and please be sure to complete an attestation once the courses are completed.
Providers who are contracted with Health Partners Plans (HPP) must demonstrate that they are knowledgeable and trained on important topics annually. Participation in our quarterly provider orientation and training course satisfies this annual requirement. The course offers a detailed overview of HPP and gives valuable information to meet the needs of our members. Topics include: claims information, member ID cards, on-line tools and prior authorization guidelines.
This course provides an overview of Health Partners Plans (180) calendar day process for submitting or resubmitting Claims for proper review and/or processing within an accurate Time Frame. Also provided is an overview of the Claims Reconsideration Appeals process with the steps and appropriate documentation needed for review and determination.
During this course you’ll learn how to access our clinical programs and resources for patients, including:
• Identification and appropriate referral for mental health
• Drug and alcohol and substance abuse services
• Sensitivity training on diverse and Special Needs populations such as persons who are deaf or hard of hearing
• How to obtain sign language interpreters and how to work effectively with sign language interpreters.
Also Cultural Competency and Treating Special Needs populations, including the right to treatment for individuals with disabilities.
Part 1 of this course offers information to providers regarding the Medicaid and CHIP Member Complaint and Grievance process, and how providers can submit Complaint and Grievance requests to the Plan on behalf of their patients who are Plan members. Part 2 of this course offers information to providers regarding the Medicaid and CHIP Member Utilization Management Authorization request process, and the need to provide supporting clinical documentation and orders required for a medical necessity review.
This course provides an overview of Jefferson Health Plans’ Medicare Advantage Plans, and an understanding of the values/benefits Jefferson Health Plans Medicare offers our members. Topics include copay and prescription drug coverage, and enhanced supplemental benefits such as vision, dental, flex cards, transportation and much more.
This course is designed to give you an overview of the Jefferson Health Plans Individuals and Families product. The enrollment process will be explained, as well as a summary of the 10 new Individuals and Families plans offered in Bucks, Montgomery and Philadelphia counties.