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Welcome to Johns Hopkins HealthCare LLC
Johns Hopkins HealthCare LLC (JHHC) provides health care services for four health plans: Priority Partners Managed Care Organization, Johns Hopkins Employer Health Programs (EHP), Johns Hopkins US Family Health Plan (USFHP) and Johns Hopkins Advantage MD (Advantage MD). This site provides our medical health providers with general plan information, current news, and plan updates.
Log in to your HealthLINK account to view information on your EHP/Priority Partners/Advantage MD patients.
Log in to your HealthLINK account to view information on your USFHP patients.
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Priority Partners Policy Changes to Opioid Prescribing
Effective July 1, 2017: The Department of Health and Mental Hygiene (DHMH), Priority Partners (PPMCO) and seven other Medicaid Managed Care Organizations (MCOs) in the Maryland’s HealthChoice Program will implement several policy changes pertaining to opioid prescribing. Learn about the changes in opioid prescribing.
Tier Changes to TRICARE Formulary Drugs
The Department of Defense Pharmacy & Therapeutics (DoD P&T) Committee oversees the TRICARE Management Activity drug formulary. The DoD P&T has recommended changes to certain prescription drugs that will move them to the non-formulary level (Tier 3) or will require prior-authorization. Learn more about the affected drugs.
Johns Hopkins Fax Lines Down for Maintenance
Johns Hopkins fax lines will be down for maintenance during the evening of April 27th, from 6 p.m. until 12:30 a.m. on April 28th. You may experience a busy signal if trying to fax during this time.
Provider Outreach and Education Seminar
The provider relations department is hosting a two-part seminar series. Part I, "The Inside Story: Coding and Introduction to Risk" is intended for practice administrators, billing and coding staff, and lead physicians. We will discuss accurate medical record documentation and coding practices, and best practices for appropriately capturing provider and patient interactions for quality documentation and complementary coding. Read more about the provider seminar.
Johns Hopkins Advantage MD Pre-Authorization Guidelines Update
The updates are in alignment with industry standard and will be effective April 15. Read more about the Advantage MD pre-authorization guidelines update.
Emergency Room Facility Update
Summary of Change: Effective March 23, 2017, EHP will follow the ER sudden and serious auto pay list for facility emergency services for members covered under the EHP medical plans for Johns Hopkins Hospital, Johns Hopkins Bayview, and Johns Hopkins Health System with group numbers: E00090, E00091, E00092, E00093, E00190, E00192, E00194, E00198, E00006, E00007. Read more about the ER sudden and serious criteria.
Medical Policies Update
JHHC issued a fax and email to providers in December regarding the most recent medical policy updates that go into effect 1/16/17. For questions, please call Provider Relations at 1-888-895-4998.
CMS11.03 Observation Policy Revised for PPMCO Providers
The observation policy has been revised and is effective 1/1/17. View the revised observation policy.
2017 Outpatient Referral Guidelines
The 2017 Outpatient Referral & Pre-Authorization Guidelines for Advantage MD, EHP, Priority Partners, and USFHP are now posted on the Resources and Guidelines page.