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For newly contracted providers seeking a more comprehensive orientation and training, please contact us at providereducation@jeffersonhealthplans.com.
For established contracted providers who have already completed the initial comprehensive orientation and training and looking for a more concise yet impactful and informative session, please follow the link to Annual Training for Network Providers (ATP)
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Contracted providers are required to annually demonstrate their knowledge and training on key topics. Participation in our provider orientation and training course fulfills this annual requirement. This course provides a comprehensive overview of our plans and essential information to meet our members' needs. Topics covered include: 2025 updates, product overview, member ID cards, credentialing, claims filing instructions and best practices, online tools, Community HealthChoices program, Pay-for-Performance and Quality Care Plus, EPSDT standards, and much more. |
| For ancillary contracted providers who are seeking a more comprehensive orientation and training, please follow the link to Annual Training for Ancillary Providers (ATAP). |
Our comprehensive training session is designed for contracted ancillary providers and will cover a range of topics, including 2025 updates, claim filing instructions and best practices, credentialing, utilization management and prior authorization, Evicore, and other valuable resources. The training is tailored to the services provided by the following provider types:
Radiology
Home Care
Home Hospice
Home Infusion
Transportation
Home Health Aide
Ambulatory Surgical Center
Skilled Nursing Facility (SNF)
PT, OT and Speech Therapy
Durable Medical Equipment
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| Timely Filing Protocols and The Reconsideration Process |
This course provides an overview of our 180-day process for submitting or resubmitting claims for proper review and/or processing within an accurate time frame. Topics also include an overview of the claims reconsideration appeals process with the steps and appropriate documentation needed for review and determination. |
| Cultural Competency and Linguistic Requirements and Services |
This course teaches you 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 and how to obtain sign language interpreters and work effectively with sign language interpreters. The course also includes information on cultural competency and treating Special Needs populations, including the right to treatment for individuals with disabilities. |
| Complaints, Grievances and Medical Necessity Reviews |
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.
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| Overview of 2025 Medicare Advantage Products |
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. |
| Jefferson Health Plans: Individual and Family Plans 2025 Plan Year Overview |
This course provides a comprehensive overview of the Individual & Family Plans (Affordable Care Act (ACA)), focusing on the key features, benefits, and enrollment process. You’ll gain insight into the 2025 offerings from Jefferson Health Plans (JHP), including the ACA HMO and PPO plans that are available. |
