Contact Us
Our teams are available to support our in-network providers and hospital partners. Please refer to the contact information below to connect with the team best suited to address your needs.
Claims Status, Inquiries and Reconsiderations:
To fax prior authorization requests, please use the numbers below:
• Medicaid: 1-866-240-3712
• Medicare Advantage: 1-866-371-3239
• Individual and Family Plans: 1-833-605-4407
• Ancillary Services (DME, home health care): prompts 2, 2
• Inpatient/Outpatient Services: prompts 2, 3
• Non-Par Service Requests: prompts 2, 4
• Physician Peer-to-Peer Hotline: prompts 2, 1
• Medicare: 215-991-4395
• Medicaid: 267-385-3825
• Fax: 215-991-4125
Credentialed Provider Linkages, Terminations and Demographic Updates/Changes:
DataValidation@jeffersonhealthplans.com
Fax: 267-515-6650
Hospital/Facility-Based and Physical/Occupational/Speech Therapy Linkages, Terminations & Changes:
ProviderData@jeffersonhealthplans.com
Fax: 215-967-9274
Site Relocation or Closures, NPI and Promise ID Changes:
Credentialing Status, Correspondence & Enrollment:
Credentialing@jeffersonhealthplans.com
Fax: 215-967-4473
STARS/HEDIS Initiatives:
Hedis_records@jeffersonhealthplans.com
Fax: 215-967-9230
Quality of Care/Complaints:
quality@jeffersonhealthplans.com
Fax: 267-515-6648
Care Gaps:
caregap_records@jeffersonhealthplans.com
Fax: 215-967-9230
Audits:
audit@jeffersonhealthplans.com
Fax: 215-967-4477
Quality Management Department: 1-855-218-2314
Refer patients by:
Phone: 1-215-845-4797 or Email: clinicalconnections@jeffersonhealthplans.com
For initial contracts, changes in group/practice ownership, and Tax ID changes:
To report an actual or suspected Compliance, Privacy, or Fraud, Waste or Abuse incident:
Call 1-866-477-4848. You may remain anonymous.
Reporting cases of suspected Fraud, Waste, or Abuse online:
https://secure.ethicspoint.com/domain/media/en/gui/1003032/index.html
Email one of the following:
• compliance@jeffersonhealthplans.com
• siutips@jeffersonhealthplans.com
• specialinvestigationsunit@jeffersonhealthplans.com
External Reporting Agencies:
• The CMS Medicare Hotline - 1-800-MEDICARE (1-800-633-4227)
• Medical Assistance Provider Compliance Hotline - 1-844-DHS-TIPS (1-866-379 8477)
For general provider education and training inquiries:
For general inquiries not addressed by areas listed above:
1-888-991-9023 | Monday - Friday - 9 a.m. to 5 p.m.