Health Partners: In Wellness and Health, Partners for Life.

Home | Contact Us | Site Map

Health Partners is the Philadelphia area’s
only health plan owned by a partnership of local hospitals.

Saturday, July 26, 2008

	Find a Doctor (PROVIDER Plus+)

	Provider Connect
	(Claims/Eligibility Status)

	HIPAA Connect / EDI Claims

	Claim Processing Info

	Form and Supply Requests

	Quick Reference Guide

	Clinical/Preventive Guidelines/DM

	Health Partners Formulary

	Provider Manual

	Newsletters & Bulletins

	Site Visit/Medical Record Review

	Fraud & Abuse Info & Hotline

Health Partners Provider Manual

Thank You for Using our Provider Manual Online!

The new Health Partners Provider Manual has been updated to reflect current Health Partners policies and procedures, as well as applicable changes to Medical Assistance benefit packages.

Each section (such as Provider Billing and Utilization Management) is posted individually for easier reference. Additional updates will be added as appropriate throughout the year.

Each section is a PDF document that can be printed in part or in its entirety. You can also use the search capabilities of the PDF format by:

Clicking on the “binocular” icon on the tool bar above the document. This will allow you to type in key words to reach related topics within each section.
Clicking on the “bookmarks” to the left of the section. Certain bookmarks begin with a + (plus) sign to further aid you in your navigation. Click on the + (plus) sign and the subsection links will appear.

Please note that ownership of the Senior Partners Medicare plans was transferred to Bravo Health as of August 1, 2007.The Senior Partners information included in the Provider Manual posted here is provided for your reference (for open claims, etc.) concerning Medicare coverage provided by Health Partners prior to the change in ownership.

Some sections of the Provider Manual were re-numbered in 2007. Please use the section titles, or refer to the Table of Contents, to readily find the information you’re seeking.

Your feedback is very important to us. If you have any recommendations for the manual or its online presentation, please share them by clicking here. Or call our Provider Services Helpline at 215-991-4350 or 1-888-991-9023.

   Table of Contents (4/08)

   Introduction (11/07)

   Frequently Asked Questions (11/07)

   Health Partners Eligibility and Enrollment (11/07)

   Health Partners Benefits (1/08)

   Utilization Management (2/08)

   Quality Management (10/07)

   Provider Practice Standards & Guidelines (12/07)

   Provider Billing (11/07)

   Problem Resolution (4/08)

   Appendix (4/08)