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Provider News
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2020
- Health Partners (Medicaid) CG&A Change
- HPP Changing Telehealth Services Requirements in Response to COVID-19
- HealthRules Payor—New Claims Platform Implementation for Medicaid
- 2020 Rewards Now Available for Health Partners, KidzPartners Members
- InterQual Criteria
- Provider Check-In
- Tri-Tech Health Announcement
- The Spring Issue of Provider Check Up is Now Available!
- Improving Provider P4P Measures Webinar: Medication Adherence for Members with Chronic Conditions
- NCQA Announces Changes and Adjustments
- The Fall Issue of Provider Check Up is Now Available!
- HealthRules Payor—New Claims Platform Implementation for Medicare
- Spirometry Testing in Primary Care
- eviCore Portal Enhancements
- Expansion of CHIP Program Offering
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2019
- Reminder: Pennsylvania License Requirements
- Routine Foot Care for Health Partners (Medicaid) Adult Members
- Provider Orientation and Training Webinar: Wednesday, February 20, 2019
- 2019 Quality Care Plus Program
- DHS Enrollment Required by July 1, 2019
- Changes to Prenatal Billing Requirements
- Pay-for-Performance (P4P) Provider Initiatives Webinar Series Begins March 27, 2019
- Cut Through the Confusion: Understanding Health Partners Medicare and Community HealthChoices (CHC)
- Insulin Glargine Formulary Change (Basaglar to replace Lantus)
- Annual D-SNP Model of Care Training – Required
- 2019 Maternity Quality Care Plus Program
- Webinar Invitation: Continuity of care, provider communication, and optimal reimbursement begin in a patient’s chart
- Congestive Heart Failure Self-Management for Health Partners Medicare Patients
- Provider Orientation and Training Webinar: Wednesday, May 15, 2019
- HEDIS Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)
- Provider Webinar: Care Coordination Support and Your Patients, June 6
- Now Available for Download: Recent HPP Webinars
- Wellness Rewards: Our Improved Medicare Incentive Program
- Tips for Boosting CAHPS Scores... and How It Can Help Your Practice
- Shift Care Staffing and Reporting – Upcoming Webinars
- Certifications for Small Businesses (SBs) and Small Diverse Businesses (SDBs)
- Reportable Conditions – PA-NEDSS
- Proper Billing for Combined Sick Visits and Well-Child Visits (Modifier 25)
- Access, Appointment & Availability Standards
- Pennsylvania Perinatal Quality Collaborative (PA PQC)
- Medicaid Specialty Pharmacy Update
- Our Spring 2019 Provider Newsletter is Now Available
- Best Practices for Your Youngest Patients
- Immunizations for Health Partners (Medicaid) and KidzPartners Members
- The Opioid Epidemic
- New Diabetes Incentive for Health Partners (Medicaid) Members
- Medicare Diabetes Prevention Program (MDPP) Sites Expanded
- Hospital Readmissions: Peer-to-Peer Reviews
- HP Connect Provider Portal Enhancements
- Reminder—2019 HPP Benefits Available
- Register Now: Provider Orientation and Training Webinar Registration Scheduled for August 21
- Breast Pump Purchases and Rentals
- Elimination of Lump-sum Purchase Option for Power Wheelchairs and Accessories over $500
- HealthRules Payor—New Claims Platform Coming October 1
- Talk to Patients about the Importance of Preventive Screenings
- Medical Records Requirement (BPI)
- Reminder: Provider Orientation and Training Webinar to be held Wednesday, August 21
- Change regarding HCPCS Code T1015
- Oral Health and Preventive Care in Your Medical Office—Revenue Opportunities for Fluoride Varnish Certification
- CCMP Updates Scheduled for September 16, 2019
- Register Now: Maternity Authorizations and Claim Submissions Webinar (9/26)
- 2019 Wellness Rewards Program available for Health Partners (Medicaid) and KidzPartners members
- HealthRules Payor—New Claims Platform Implementation Delayed for Medicaid and Medicare
- Health Partners Plans to start Synagis Prior Authorizations Process on October 15
- New Medical Necessity Policy: Peroral Endoscopic Myotomy (POEM) to be implemented 11/1/2019
- Register Now: Tobacco, Nicotine and Vaping: Prevention and Treatment Webinar (11/13)
- Updated Medical Necessity Policy: Whole Genome Sequencing/Whole Exome Sequencing to be implemented 12/1/2019
- New Reimbursement Policy: Professional Telehealth Services to be implemented 12/1/2019
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2018
- Updated 2018 HPP Provider Manual Now Available (Medicare Specialist Referrals)
- Specialist Referral Requirement (Medicare)
- Top 5 Tips for Boosting Member Satisfaction Scores
- The February 2018 Provider Newsletter is Now Available
- Refer eligible Medicaid patients to local Diabetes Prevention Program in April
- The April 2018 Provider Newsletter is Now Available
- Top 5 Tips for Improving Front-Office Customer Service
- Specialist Referral Requirement – HP Connect Provider Portal
- How Focusing on the Health Outcomes Survey (HOS) Can Improve Your Practice
- The June 2018 Provider Newsletter is Now Available
- Improve Health Outcomes with Preventive Screenings
- Home Health Prescribing by Non-Physicians
- Implementation of the 2018 InterQual Criteria
- Please take our HPP Provider Communication Survey
- A Rise in STD Cases and an Emerging Resistance to Antibiotics
- Prepare Your Office for Annual Checkups and Well-Child Visits
- Opioid Awareness
- The Winter 2018 Provider Newsletter is Now Available
- Prior Authorizations for Behavioral Health Transports
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2017
- Continuing Webinar Series: Topical Fluoride Varnish Certification Course
- The May 2017 Provider Newsletter is Now Available
- Quality Management Program Resources Available Online
- The July 2017 Provider Newsletter is Now Available
- Prior Authorizations for Opioid Prescriptions
- ONAFs Now Online
- Top Five Ways to Prepare for Back-to-School Season
- The November 2017 Provider Newsletter is Available
- DHS Requirement Regarding CHIP Enrollment
- Now Available: New Maternity/Newborn Admission Authorization Request Form
- Faxed ONAFs and One-Time Incentive Program End December 31, 2017
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2020
- Eligibility and Claims
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Clinical Info
- Antidepressant Medication Management Resources
- Antipsychotic Medication Adherence Tools
- Care Management Programs
- Clinical Care Guidelines
- Developmental Screenings
- Diabetes Prevention Program
- EPSDT/Lead Screening
- Oral Health Resources for Primary Care
- Patient Safety Reporting
- Pay-For-Performance (P4P) Program
- Preventive Care Guidelines
- Provider Notice
- Specialty Medications and Pharmacies
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Plan Info
- Provider Newsletters
- Baby Partners
- Site Visit/Medical Record Review
- Fraud & Abuse Training Information & Hotline
- Radiology Management Program
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- Smoking Cessation
- Breast Pump Purchases and Rentals
- Member Care FAQs
- Population Assessment
- Quality Management Resources
- Authorization of PT/OT/ST Services
- Provider Education Attestation
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- Subcontractor Fraud, Waste and Abuse Training Attestation Form
- Health & Wellness
- In The Community
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About Us
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Newsroom
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News Releases
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2016
- City of Philadelphia's Liberty Bell Award to William S. George
- Dr. Reetika Kumar Named Senior Medical Director of Health Partners Plans
- Denise Croce Named Executive Vice President of Clinical and Provider Management at Health Partners Plans
- Lisa Getzfrid Named Senior Vice President of Operations and Chief Operating Officer for Health Partners Plans
- Philadelphia 4th Grader Wins HPF Healthy Advances Award
- Health Partners Plans Welcomes Christian Sondergaard as Director of Investigations and Subrogation
- At-Home FIT Kits Offer Convenience While Fighting Colorectal Cancer
- Philadelphia 11th Grader Wins HPF Health Tech Award
- HPP President and CEO William S. George Named PCCY Public Citizen of the Year
- Health Partners Plans Receives International Recognition for Creative Communications and Innovative Marketing
- Health Partners Plans Receives Prestigious Award for Creative Advertising
- Health Partners Plans President and CEO to Serve as Chairperson at World Congress Summit in Boston
- Health Partners Plans Among Top 15 Medicaid MCOs in the Country
- President and CEO William S. George Invited to Present Innovative Food Access Program at Harvard University
- Health Partners Medicare Expands to Lancaster, Lehigh and Northampton Counties
- Health Partners Plans Names Kalyan Narayanan Vice President and Chief Technology Officer
- Mark Cary Named Senior Vice President of Medicare Sales and Actuarial Services for Health Partners Plans
- Health Partners Plans Wins Gold in International Competition for Marketing and Communications Excellence
- Health Partners Plans Names Beverly Collins Vice President, Chief Quality Officer
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2017
- Health Partners Plans Names Matthew Post Vice President of Medicare Sales
- Health Partners Plans Awarded the NCQA Multicultural Health Care Distinction for Fourth Consecutive Year
- Health Partners Plans Names Bill Vazquez Vice President of Innovations
- Health Partners Plans Selected to Serve Medicaid Beneficiaries in Pennsylvania’s Southeast and Lehigh/Capital Zones
- Health Partners Plans Names Anthony Marino Vice President, IT Infrastructure and Operations
- Philadelphia District Attorney Candidates Make Their Cases at Health Partners Plans
- Health Partners Plans Announces Unprecedented Fitness Partnership with YMCA of Greater Brandywine
- Steve Schlager Named Senior Vice President and General Manager of Central Pennsylvania for Health Partners Plans
- Eric Huss Named Executive Vice President of Finance and Administration for Health Partners Plans
- Health Partners Plans Launches Community-Focused Program to Promote Wellness among Southeastern PA Families
- Health Partners Medicare Reaches New Membership Milestone
- Howard Lu Named Vice President and Chief Clinical Officer for Health Partners Plans
- Music Superstar Jazmine Sullivan Joins Health Partners Plans in Uniting Communities at Health & Music Festival
- Health Partners Plans Among 11 Medicaid Plans in Nation Awarded “Excellent” by NCQA
- Health Partners Plans Connects Young African Leaders with PA Legislators
- Health Partners Plans Presents Results of Groundbreaking Food Access Program at World’s Largest Nutrition Conference
- Geralynn Boone Named Vice President of Medicare Clinical Operations for Health Partners Plans
- Health Partners Medicare Offers Pennsylvanians Affordable Plan Premiums as Low as $0 for Fifth Year in a Row
- Margaret Worek Caroccia Named Senior Vice President of Operations for Health Partners Plans
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2018
- Groundbreaking Partnership Connects Homeless People to Vital Health Care Services
- U.S. Department of Labor Invites Health Partners Plans to Lead Workshop in Honor of African American History Month
- Health Partners Plans Publishes Results of Groundbreaking Food as Medicine Program in Call to Action
- Health Partners Plans Hosts Candidates for Pennsylvania Lt. Governor
- Barry Volin Named Executive Vice President of Medicare and Operations for Health Partners Plans
- Health Partners Plans Leaders Invited to Present Innovative Approach to Value Based Care at Nation’s Leading Healthcare Finance Association
- Health Partners Plans Employees Honored for Working with Intellectually Disabled Citizens
- Health Partners Plans and Cradle of Liberty Council, Boy Scouts of America, Sponsor New Boy Scout Troop Focused on Health
- Health Partners Plans Proud Sponsor of Pennsylvania’s First-Ever Latino Health Summit
- Health Partners Plans President and CEO to Address U.S. Congressional Briefing About Results of Groundbreaking Food as Medicine Partnership
- Health Partners Plans Featured in Pennsylvania Department of Human Services’ Medicaid Innovation Tour
- Health Partners Plans to Share Groundbreaking Food is Medicine Partnership at Tulane University Culinary Medicine Conference
- Jenny Fong Named Senior Vice President of Medicare and Operations for Health Partners Plans
- Health Partners Plans Names Hicham Elanmati Vice President of Sales, Medicare Advantage
- David Naramore Named Vice President and Chief Actuary for Health Partners Plans
- Health Partners Medicare Offers Affordable Plans with Valuable Benefits at No Additional Cost
- For Second Year in a Row, Health Partners Plans Is Awarded “Excellent” Accreditation Status by NCQA
- National Leaders Focused on Health Equity Gather in New Orleans to Address Social Determinants of Health
- James Hynek Named Senior Vice President of Finance for Health Partners Plans
- Brian K. Donovan Named Vice President of Network Management for Health Partners Plans
- Health Partners Plans Earns NCQA Multicultural Health Care Distinction Status for Fifth Consecutive Year
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2019
- Health Partners Plans Executives Volunteer in MANNA’s Kitchen
- Free Foot Exams and Footwear Offered to Those Experiencing Homelessness
- Health Partners Plans President and CEO William S. George To Retire; Executive Vice President Denise Croce Named President and CEO
- Health Partners Plans to Support Aspiring Women Leaders in Healthcare, Staci Scott to Share her Inspiring Journey at Inaugural Conference
- Health Partners Plans Rallies to Help Community Members Facing Food Insecurity Due to Delayed SNAP Benefits
- Health Partners Plans Becomes FIRST Managed Care Organization in Southeastern PA to Open a Community Wellness Center in West Philadelphia
- Health Partners Foundation Helps Drive Conversation on African-American Women in Philanthropy
- Health Partners Plans Proudly Sponsors Pennsylvania’s Second-Ever Latino Health Summit
- Health Partners Plans Now Offers Health and Wellness Workshops Online
- Renee Mercer Named Vice President of Member and Provider
- Health Partners Plans’ Employees Address SDoH in Nigeria
- Health Partners Plans Unveils Powerful Tools of Support, Compassion in Fight against Opioid Addiction
- Health Partners Plans to Host a Career Day for Local Job Seekers
- Health Partners Medicare Offers Affordable Plans with New Benefits and No Referral Requirements
- Health Partners Plans Remains Among Highest-Rated Medicaid Plans in Pennsylvania
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2020
- Health Partners Plans Announces Literacy Initiative to Assist Children During COVID-19 and Beyond
- Health Partners Plans Names Kevin Clancy as Chief Financial Officer
- Health Partners Plans and Children’s Hospital of Philadelphia Announce Agreement
- Health Partners Plans Expands Commitment to Social Determinants of Health by Launching PartnerUp HealthCompass, Convening First-Ever Regional Council
- Health Partners Medicare Announces 2021 Plan Offerings with New and Expanded Benefits
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2016
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