November 25, 2024

Thank you for being a valued provider for members in one or more of our health plans: Health Partners Plans Medicaid and Health Partners Plans CHIP, Jefferson Health Plans Medicare Advantage, and/or Jefferson Health Plans Individual and Family Plans.

Effective January 1, 2025, prior authorization will no longer be required for cardiac magnetic resonance imaging for the quantification of segmental dysfunction, transthoracic (TTE) and transesophageal (TEE) echocardiogram services for participating providers.

Certain cardiac services, including cardiac implantables (pacemakers and defibrillators), cardiac catherizations, and nuclear stress tests, will still require prior authorization and should continue to be submitted via eviCore.

This change applies to all of our lines of business (Health Partners Plans Medicaid, Health Partners Plans CHIP, Jefferson Health Plans Medicare Advantage, and Jefferson Health Plans Individual and Family Plans).  

Non-participating providers may require authorization as a condition of payment based on the member's individual coverage.  For information on products/services that require authorization as a condition of payment for out of network services, please contact the Utilization Management/Prior Authorization line at 1-866-500-4571, prompts 2, 4.

For specific code-level details, or if you have any questions, please visit our Prior Authorizations page or contact our Provider Services Helpline at 1-888-991-9023 (Monday - Friday, 9:00 a.m. – 5:30 p.m.).