Provider Communications
Find all of the communications and updates sent by Johns Hopkins Health Plans.
If you have any questions, please contact our Provider Relations department at 888-895-4998 (option 4).
Repository
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February
- Important Alert: Fraudulent Faxes Reported (2/6/2025)
- Telehealth Code Changes for USFHP Effective March 7 (2/4/2025)
- Required Training: Johns Hopkins Advantage MD D-SNP Webinar (2/4/2025)
January
- New LDT Codes for USFHP Effective March 25 (1/24/2025)
- Reminder: Mailing Address for USFHP Paper Claims, Documents (1/21/2025)
- New MDH Behavioral Health Vendor (1/16/2025)
- Upcoming Webinars: Provider Orientation & Plan Updates (1/16/2025)
- Required Training: Johns Hopkins Advantage MD D-SNP Webinar (1/16/2025)
- New Reimbursement Policies Effective March 15, 2025 (1/14/2025)
- Correction: USFHP Prior Authorization Changes Effective March 1 (1/14/2025)
- Complete Medical Records Request for HEDIS® MY 2024 (1/13/2025)
- New Prior Authorization Requirements Effective March 15 (1/10/2025)
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December
- USFHP Prior Authorization Changes (12/27/2024)
- Changes to ED Review Policy and Sudden & Serious List (12/27/2024)
- Medical Policy Change for Site of Service Outpatient Procedures (12/20/2024)
- 2025 Part D Coverage Changes for Advantage MD (12/19/2024)
- Authorization Changes for Cardiac Rehab Codes (12/12/2024)
- USFHP Prior Authorization Changes Effective Jan. 20, 2025 (12/10/2024)
- What to Expect in 2025 for Johns Hopkins Health Plans (12/10/2024)
- Fall 2024 Issue of Provider Pulse Now Available (12/6/2024)
November
- Quarterly Medical Policy Changes Jan. 1, 2025 (11/29/2024)
- Authorization Changes for Codes Effective Jan. 1, 2025 (11/29/2024)
- Cultural Competency Training Requirement and Attestation (11/27/2024)
- New Code Change (81515) for USFHP Effective Jan. 1, 2025 (11/27/2024)
- Emergency Department Facility Claims Review (11/22/2024)
- We’re Listening! Complete Our Provider Survey. Deadline December 16 (11/18/2024)
- Webinars: Johns Hopkins Health Plans Provider Orientation & Updates (11/15/2024)
- New Prior Authorization Requirements for Certain Medications (11/14/2024)
- Updates to Reimbursement Policies Effective Dec. 27, 2024 (11/12/2024)
- New Priority Partners Doula Program Now Available (11/8/2024)
- Register Today! Nov. 14 Webinar on Virtual Behavioral Health Care (11/7/2024)
- New Anesthesia Reimbursement Policy (RPC.007) Effective Dec. 2 (11/1/2024)
October
- USFHP Hearing Benefit Expansion and Behavioral Health Services Audit (10/31/2024)
- Coding and Form Change for Advantage MD WHA Effective Jan. 1, 2025 (10/22/2024)
- Webinar: Connect Your Patients to Virtual Behavioral Health Care (10/17/2024)
- USFHP Procedure Code Authorization Changes Effective Nov. 16 (10/15/2024)
- Tips and Info: Navigating MDH’s ePREP Portal for Priority Partners (10/8/2024)
- Advantage MD Discontinuing Premier (PPO) Plan for 2025 (10/3/2024)
- Upcoming Claims Audit: Alaffia Health to Assist (10/3/2024)
- Procedure Codes Authorization Changes Effective Nov. 1 (10/1/2024)
September
- Prior Authorization Lab Codes Changes for Priority Partners (9/24/2024)
- Webinar: Learn More About UpLift (9/6/2024)
- Changes to Emergency Department Review Policy Effective Nov. 1 (9/5/2024)
- New Reimbursement Policy (RPC.040) Effective Nov. 1 (9/5/2024)
- Updated Reimbursement Policy (RPC.037) Effective Oct. 18 (9/3/2024)
August
- Correction: Quarterly Medical Policy Updates Effective Oct. 1 (8/30/2024)
- New Issue of Johns Hopkins Health Plans Provider Pulse Available (8/30/2024)
- Webinars: Johns Hopkins Advantage MD D-SNP Provider Training (8/27/2024)
- New Prior Authorization Requirements for Certain Medications (8/27/2024)
- New Codes Requiring Prior Authorization Effective Oct. 1 (8/21/2024)
- Medical Policy Updates Effective Oct. 1 (8/20/2024)
- Webinar: Johns Hopkins Health Plans Provider Orientation & Updates (8/16/2024)
- Reimbursement Policies Effective Sept. 15, 2024 (8/15/2024)
- JPAL Updates for Advantage MD and Priority Partners Codes (8/15/2024)
- Prior Authorization and Coverage Changes for US Family Health Plan (8/6/2024)
- Changes to Emergency Department Review Policy Effective Oct. 1 (8/1/2024)
- Priority Partners Reimbursement Policies Effective Oct. 1 (8/1/2024)
July
- New Claims Mailing Address for USFHP Beginning Aug. 1 (7/26/2024)
- EHP Recent Prior Authorization Changes for Unlisted Codes (7/25/2024)
- Advantage MD Recent Code and Prior Authorization Changes (7/24/2024)
- Reimbursement Policies Effective Sept. 6, 2024 (7/18/2024)
- Upcoming Webinar: Provider Orientation & Plan Updates (7/16/2024)
- Recent Prior Authorization Changes for USFHP Effective Aug. 17 (7/15/2024)
June
- New Reimbursement Policies Effective August 15, 2024 (6/27/2024)
- Prior Authorization Hospice Code Changes for Priority Partners (6/27/2024)
- REMINDER: Provider Payments Resume for Advantage MD and USFHP (6/21/2024)
- Provider Payments Resume for Advantage MD and USFHP (6/17/2024)
- New Obstetrical Services Reimbursement Policy for EHP and USFHP (6/6/2024)
- Changes to Emergency Department Review Policy (6/3/2024)
May
- New Issue of Johns Hopkins Health Plans Provider Pulse Now Available (5/31/2024)
- New Codes Requiring Prior Authorization for Advantage MD Effective July 1 (5/31/2024)
- Appropriate Claim Change Reason Codes Required (5/28/2024)
- Medical Policy Updates Effective July 1, 2024 (5/23/2024)
- Prior Authorization and No Prior Authorization Code Changes (5/21/2024)
- New Obstetrical Services Reimbursement Policy for Priority Partners (5/17/2024)
- New Reimbursement Policies Effective July 5 (5/14/2024)
- Effective Immediately: New Availity Authorization Status Process (5/9/2024)
- Availity Portal Expansion Coming May 20. Training Opportunities Available. (5/7/2024)
- New Prior Authorization Requirements For Certain Medications Effective June 1 (5/1/2024)
April
- REMINDER: New Claims Payments/Remittance Providers (4/22/2024)
- April Webinar: Johns Hopkins Health Plans Provider Orientation/Plan Updates (4/22/2024)
- Johns Hopkins Health Plans Transitions to Epic Platform for Reviews (4/19/2024)
- New CPT® Codes Requiring Prior Authorization Effective May 15 (4/15/2024)
- Recent Code Changes for Johns Hopkins Health Plans (4/15/2024)
- New Claims Payments/Remittance Providers for Advantage MD and USFHP (4/12/2024)
- New Reimbursement Policies Effective June 10 (4/10/2024)
March
- Authorization Process for Mt. Washington Pediatric Hospital (3/28/2024)
- Webinar: Johns Hopkins Health Plans Provider Orientation & Plan Updates (3/25/2024)
- New Issue of Provider Pulse Now Available (3/19/2024)
- Corrected Process for Maryland Prenatal Risk Assessment (MPRA) Forms (3/8/2024)
- Update to the Johns Hopkins Health Plans Peer-to-Peer Process (3/5/2024)
- New Preferred Med List and Prior Authorization Process for Priority Partners (3/1/2024)
February
- Change Healthcare Incident (2/29/2024)
- New CPT® Codes Requiring Prior Authorization for Advantage MD (2/29/2024)
- JHU Retirees No Longer Enrolled in EHP Effective April 1 (2/29/2024)
- Changes to the Low Back Pain Policy for USFHP (2/27/2024)
- Reminder to Update Provider Demographic Information (2/27/2024)
- Breast Reduction Surgery Added to Site of Service Policy Effective April 1 (2/22/2024)
- Prior Authorization Requirements For Certain Medications Effective April 1 (2/22/2024)
- CORRECTION: Prior Authorization Change for Prenatal Screening for USFHP (2/20/2024)
- Medical Policy Updates Effective April 1 (2/20/2024)
- 2024 Behavioral Health Services Requirements and Audit Process for USFHP (2/12/2024)
- New CPT® Codes Requiring Prior Authorization Effective March 6 (2/6/2024)
- New Prior Authorization Requirements For Certain Medications Effective April 1 (2/5/2024)
- Prior Authorization Changes Effective Mar. 15 (2/1/2024)
January
- Prior Authorization Changes for Specific Prenatal Screening for USFHP (1/30/2024)
- Prior Authorization Changes for Selected Codes (1/30/2024)
- Recent Code Changes for Johns Hopkins US Family Health Plan (1/9/2024)
- New CPT® Codes Requiring Prior Authorization Effective Feb. 19 (1/19/2024)
- Postponed: Anesthesia Reimbursement Policy (1/18/2024)
- Zoom Webinars: Advantage MD D-SNP Provider Training (1/11/2024)
- Medical Policy Updates Effective Feb. 1 (1/4/2024)
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December
- Medical Policy Updates Effective Jan. 1, 2024 (12/21/2023)
- New Program for Specialty Medications, PrudentRx (12/21/2023)
- New Reimbursement Policies Effective Feb. 1, 2024 (12/19/2023)
- Zoom Webinar: What's in Store in 2024 for Johns Hopkins Health Plans (12/8/2023)
- Reminder to Update Demographic Information (12/6/2023)
- Manual BP Monitors Not Covered for USFHP Effective Dec. 11, 2023 (12/6/2023)
- Reminder: Accepted Addresses for Remitting Overpayments (12/5/2023)
November
- New CPT® Codes Requiring Prior Authorization Effective Jan. 1, 2024 (11/30/2023)
- Changes to Prior Authorization Requirements Effective Jan. 10, 2024 (11/28/2023)
- New and Revised Reimbursement Policies Effective Dec. 30, 2023 (11/14/2023)
- Changes to Prior Authorization for Selected Codes Effective Dec. 15, 2023 (11/14/2023)
- Additional Availity Provider Training Date Added: Nov. 28 (11/13/2023)
- UpLift Virtual Behavioral Health Practice Added to Provider Network (11/7/2023)
- Johns Hopkins University No Longer Enrolled in EHP Effective Dec. 31 (11/3/2023)
- Prior Authorization Changes for Advantage MD (11/2/2023)
October
- Changes for Selected Hospice Codes for USFHP Effective Nov. 15 (10/17/2023)
- New Streamlined Process for Submitting MPRA Forms to Priority Partners (10/16/2023)
- Availity Essentials: New Provider Training Date Added (10/16/2023)
- Medical Policy Updates Effective Nov. 1, 2023 (10/13/12023)
- New Issue of Provider Pulse Now Available (10/6/2023)
- Availity Essentials, Launches October 21: Provider Training Information (10/3/2023)
- New Hearing Aid Discount Available to US Family Health Plan Members (10/2/2023)
September
- Availity Essentials, New Multi-Payer Portal, Launches October 21 (9/28/2023)
- New Prior Authorization Requirements For Certain Medications Effective Nov. 1 (9/26/2023)
- New and Revised Reimbursement Policies Effective Nov. 20, 2023 (9/20/2023)
- Johns Hopkins Health Plans New Psychotherapy Reimbursement Policy (9/19/2023)
August
- Changes to Prior Authorization Requirements Effective Oct. 14, 2023 (8/31/2023)
- Prior Authorization Requirements For Certain Medications Effective Oct. 1 (8/31/2023)
- Updated Skilled Nursing Facilities Authorization Process for USFHP (8/29/2023)
- New Multi-Payer Portal, Availity, Launching Oct. 21 (8/28/2023)
- Durable Medical Equipment (DME) Provider Search Procedures (8/22/2023)
- Johns Hopkins Health Plans Retired Reimbursement Policies (8/21/2023)
- New Requirements for Adalimumab Products for Priority Partners (8/17/2023)
- New and Updated Reimbursement Policies Effective Sept. 15, 2023 (8/15/2023)
- Healthy Babies Equity Act Effective for Non-citizen Pregnant Marylanders (8/8/2023)
- Enhanced Reimbursement for Priority Partners Maternal Health Providers (8/3/2023)
July
- Upgrade to JPAL Prior Authorization Tool For Advantage MD (7/30/2023)
- Procedure Codes Removed from Prior Authorization Effective Sept. 1, 2023 (7/25/2023)
- Medical Policy Updates Effective August 21 (07/25/2023)
- Updated Priority Partners Processes Post PHE (7/24/2023)
- New Anxiety Screening Recommendations (7/10/2023)
- Site-of-Service Policy Updates for Priority Partners and USFHP (7/10/2023)
- Johns Hopkins HealthCare Becomes Johns Hopkins Health Plans (7/7/2023)
- Post-PHE Changes for EHP Effective July 10, 2023 (7/7/2023)
- Balance Transfers from MC400 to Facets (7/6/2023)
June
- Recent Changes to COVID-19 Coverage for USFHP (6/29/2023)
- Medical Policy Updates Effective August 1 (6/29/2023)
- Student Health Program No Longer Enrolled in EHP Effective July 1 (6/20/2023)
- New Codes Requiring Prior Authorization for Advantage MD and USFHP (6/15/2023)
- Provider Pulse Spring Issue Now Available (6/12/2023)
- Revised UM Hours for After-Hours and Urgent Authorizations (6/8/2023)
- Selected DME Codes Removed from Prior Authorization Requirement (6/8/2023)
May
- New Prior Authorization Requirements for Certain Medications (5/31/2023)
- Post-PHE Reminder Regarding Peer-to-Peer Review Timeframes (5/12/23)
- Removal of Selected Procedure Codes from Prior Authorization Requirement (5/9/2023)
- Advantage MD D-SNP Annual Training Reminder (5/8/2023)
- New Venipuncture Reimbursement Policy (5/4/2023)
- Changes to the Gender Affirming Treatment Policy for EHP (5/1/2023)
- Select PT/OT Codes Removed from Prior Authorization Requirement for EHP (5/1/2023)
April
- Reimbursement for Remote Patient Monitoring for Priority Partners (4/20/2023)
- Transition After Termination of COVID-19 Public Health Emergency for USFHP (4/17/2023)
- Redetermination for Priority Partners Members (4/10/2023)
- Upgrade to JPAL Prior Authorization Tool (4/3/2023)
March
- New Prior Authorization for Certain Provider-Administered Medications (3/31/2023)
- Medical Policy Updates Effective May 1 (3/31/2023)
- Site-of-Service Medical Policy Updates for Priority Partners and USFHP (3/31/2023)
- Requesting Prior Authorization for Wound Care from eviCore (3/16/2023)
- Winter Edition of Provider Pulse Now Available (3/16/2023)
- New Prior Authorization Requirements for Advantage MD and USFHP (3/9/2023)
February
- New Prior Authorization for Certain Medications for EHP Effective Apr. 1 (2/27/2023)
- Updates to eviCore Lab Procedure Codes for Priority Partners (02/17/2023)
- Advantage MD D-SNP Annual Provider Training (2/16/2023)
- New EviCore Program for Orthopedic Pain Management (2/9/2023)
- New CPT® Codes Requiring Prior Authorization for Priority Partners (2/9/2023)
- EHP Behavioral Health Claims Payments (2/3/2023)
- Reminder: Use Updated Priority Partners Forms (2/2/2023)
January
- Changes to Dismissals and Withdrawals for Advantage MD (1/30/23)
- Reminder to Update Provider Demographic Information (1/26/2023)
- New CPT® Codes for Advantage MD Requiring Prior Authorization Effective Feb. 20, 2023 (1/20/2023)
- New Design for JHHC.com Provider Website (1/18/2023)
- New CPT® and HCPCS Codes for USFHP Requiring Prior Authorization Effective Feb. 13 (01/12/2023)
- New Prior Authorization for Certain Medications for Priority Partners Effective Mar. 1 (01/12/2023)
- Required Provider Education for Advantage D-SNP (01/09/2023)