Provider Quick Reference Guide
Provider Portal

JeffersonHealthPlans.com/Provider Portal

Services available through our portal include:

• Eligibility and benefit verification

• Claim status inquiry

• Claims reconsiderations

• Authorization requests

• Access to reports/documents/provider communications

See below for plan ID cards.

Claims Status, Inquiries and Reconsiderations:

Jefferson Health Plans recommends electronic claims submissions.

Review, inquire and appeal claims via our provider portal.

Vendor Information

Avēsis (Dental):
1-800-952-6674
www.myavesis.com/providers

Davis Vision:
1-800-773-2847
www.davisvision.com/eye-care-professionals

ECHO Health (Electronic Funds Transfer and Remittance Advice):
1-888-834-3511
www.echohealthinc.com

EviCore (Radiology, Cardiology and MSK (Joint, Spine and Pain):
1-888-693-3211
http://www.evicore.com/provider

eviCore (Radiation Oncology, Medical Oncology, Therapies (PT, OT, Speech) and Chiropractic):
1-888-444-6178

Behavioral Health Services:

Jefferson Health Plans EverWell:
https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/BehavioralHealth-MCOs.aspx

Jefferson Health Plans CHIP; Jefferson Health Plans Medicare Advantage, Individual and Family Plans:
Optum Behavioral Health
1-877-614-0484, (Monday – Friday, 8 a.m. to 8 p.m. ET)
Optum Behavioral Health Resource Guide

Lab Services:

Quest Diagnostics: 1-866-697-8378
LabCorp: 1-800-745-0233
HNL Lab Medicine: 1-877-402-4221

Jefferson Health Plans EverWell

Member ID is 9 characters, starting with numeric digits

Payor ID: #80142

Paper Claims Submissions:

Jefferson Health Plans
PO Box 21228
Tampa, FL 33622

Jefferson Health Plans CHIP

Member ID is 10 characters, starting with either a "3" or "9"

Payor ID: #80142

Paper Claims Submissions:

Jefferson Health Plans
PO Box 21228
Tampa, FL 33622

Jefferson Health Plans Medicare - Pennsylvania (HMO/DSNP and PPO)

Member ID is 7 characters, starting with "5"; PPO or HMO is identified on the ID card

  • HMO/DSNP Payor ID: #80142

  • PPO Payor ID: #RP099

HMO Paper Claims Submissions:

Jefferson Health Plans
PO Box 21228
Tampa, FL 33622

PPO Paper Claims Submissions:

Jefferson Health Plans
PO Box 21247
Tampa, FL 33622

Jefferson Health Plans Medicare - New Jersey (HMO and PPO)

Member ID is 7 characters, starting with a "5"; PPO or HMO is identified on the ID card

  • HMO Payor ID: #80142

  • PPO Payor ID: #NJ099

HMO Paper Claims Submissions:

Jefferson Health Plans
PO Box 21228
Tampa, FL 33622

PPO Paper Claims Submissions:

Jefferson Health Plans
PO Box 21367
Tampa, FL 33622

Jefferson Health Plans Individual and Family Plans

Member ID is 12 characters, starting with "J"

Payor ID: #80142

Paper Claims Submissions:

Jefferson Health Plans
PO Box 21228
Tampa, FL 33622