Thank you for your interest in joining our growing provider network!
To submit a request for consideration, please click the button below. We will review your request and a representative will contact you regarding next steps. This is not an official registration.
We use the Council for Affordable Quality Healthcare (CAQH) system for credentialing and recredentialing our providers. Visit the CAQH website to register or log in to the CAQH Universal Provider Datasource to ensure that your application is up to date.
Provider organizations who are already contracted by Jefferson Health Plans and/or Health Partners Plans and need to have a new individual provider credentialed must submit a Provider Data Collection Form. We make every attempt to complete each application within 60 days of receipt of a complete application.
If you have questions about this process, please email our credentialing department at credentialing@jeffersonhealthplans.com.
Individual providers are recredentialed within 36 months or less. Providers are notified four months prior to their recredentialing due date. Use this online form to submit a recredentialing request.
- CAQH Application
- Credentialing Standards
- Admitting Hospital Privileges/Covering Arrangement Attestation Form
- Facility Credentialing Application
- Ancillary Provider Credentialing Application
Submit completed Provider Data Collection Form via:
- Email: credentialing@jeffersonhealthplans.com
- Fax: 215-967-4473
Hospital-based providers
Submit completed hospital-based documents via:
- Email: providerdata@jeffersonhealthplans.com
- Fax: 215-967-9274