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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.
Search health topics in the Health Library.
Medical Policy Update
JHHC issued an email to providers regarding the medical policies that are effective on 04/01/19. For questions about the updates, contact Provider Relations at 1-888-895-4998 or visit our medical policies page to see the latest updates.
The Winter 2019 issue of "Provider Pulse" is now available online. The issue contains updates on claims and billing, reimbursement reminders and updates, benefits and plan changes and more.
Allergy Copay Issue
JHHC has recently discovered that the $30 copay for allergy shots was not being applied as the member’s liability for claims processed during the 2018 year. The copayment was being paid by the Health plan and rolled into the provider’s total claim payment. This issue has since been corrected and claims processed in 2019 will reflect the correct $30 member liability for these procedures.
Members affected by this issue will receive mailing informing them of the inconsistent copays and reminding them that specialty office visits require a $30 copay to be paid to the provider.
Provider Enrollment Portal - ePREP
New federal rules require that all Priority Partners providers enroll with the state’s Medicaid agency. To continue receiving Medicaid reimbursable funds, providers must submit an electronic application through the online electronic Provider Revalidation and Enrollment Portal (ePREP). Enrollment is mandatory even if you do not participate with fee-for-service Medicaid.
Providers need to register with ePREP by June 30, 2019. After that date, claims payments from unregistered providers will not be reimbursed by the state.
NOTE: Providers contracted with multiple MCOs only need to enroll one time with the state’s ePREP system. With ePREP it’s one and done.
For additional information and to complete your application, please visit health.maryland.gov/ePREP or call 844-4MD-PROV.
Pharmacy Network Change - Walgreens joins USFHP
Effective July 1, your Johns Hopkins US Family Health Plan patients will have access to all Walgreens pharmacies to fill their prescriptions. Learn more about this update.
Autism Care Demonstration Program Update for USFHP
Tricare has updated the Autism Care Demonstration (ACD) program effective January 29, 2018, TRICARE Operations Manual 6010.56-M, February 1, 2008 Chapter 18, Section 18 Department of Defense (DoD) Comprehensive Autism Care Demonstration. Learn more about the two areas that cover referrals and mandatory outcome measures.
Beginning May 31, 2018 HealthLINK will no longer work on Internet web browsers that do not support a certain level of security (also referred to as TLS 1.0). Most web browsers already support this security but some browsers may need to be updated. If you log in to HealthLINK and see a message that your browser is outdated, you will need to update it in order to use HealthLINK. You can update your browser using these instructions. If you do not see a banner when you log in, your browser is updated and there is nothing you need to do at this time.
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.