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Claims

Claims

At Johns Hopkins HealthCare LLC (JHHC), we are committed to making it easy for providers to work with us. With a dedicated claims department, you can be assured that your claims will be handled quickly and accurately. JHHC's objective is to process your claim in less than 30 days of receipt and 100% correctly. Timely filing of claims is 180 days from the date of service, unless otherwise specified in your provider agreement. The exception to this timely filing rule pertains to USFHP: The timely filing of claims for USFHP is 90 days from the date on the COB EOB.

  • Please submit paper claims for Johns Hopkins Employer Health Programs (EHP) to our corporate address:

    Johns Hopkins HealthCare LLC
    7231 Parkway Drive, Suite 100,
    Hanover, MD 21076

    Effective 12/1/2022, mail EHP paper claims to:

    EHP
    P.O. Box 4227
    Scranton, PA 18505

  • For Priority Partners paper claims, mail to:

    Priority Partners
    P.O. Box 4228
    Scranton, PA 18505 (date of service 9/1/22 or after)

  • For Advantage MD paper claims, mail to:

    Johns Hopkins Advantage MD
    P.O. Box 3537
    Scranton, PA 18505

  • For USFHP paper claims, mail to:

    Johns Hopkins HealthCare
    PO Box 830479
    Birmingham, AL 35283
    Attn: USFHP Claims Submission

You can also submit and check the status of claims through HealthLINK@Hopkins, the secure, online Web portal for JHHC providers and Priority Partners, EHP and USFHP members. Contact Provider Relations at 1-888-895-4998 to learn more.

 

Appeals

Appeals Process

Johns Hopkins HealthCare will reconsider denial decisions in accordance with the provider manual and contract. All appeal requests should be submitted in writing. For information about the appeals process for Advantage MD, Johns Hopkins EHP, Priority Partners MCO, and Johns Hopkins US Family Health Plan, please refer to the provider manuals or contact your network manager.

  • Appeals letters and other clinical information should be mailed or faxed to Johns Hopkins HealthCare.

    Address:
    Johns Hopkins HealthCare LLC
    Attn: Appeals Department
    7231 Parkway Drive, Suite 100
    Hanover, MD 21076

    Fax Number: 410-762-5304

  • Mail to:
    Johns Hopkins Advantage MD Payment Disputes
    P.O. Box 3537
    Scranton, PA 18505

    Phone: PPO: 877-293-5325, HMO: 877-293-4998; TTY users may call 711
    Fax: 1-855-206-9206

  • Effective March 21, 2022, the P.O. Box to send Advantage MD non-participating provider appeals requests is changing to:

    Mail to:
    Johns Hopkins Advantage MD Appeals
    P.O. Box 8777
    Elkridge, MD 21075

    NEW Fax: 1-410-424-2806

    Phone: PPO: 877-293-5325, HMO: 877-293-4998; TTY users may call 711

    Appeal must be received within 60 days of the denial date. All appeals requests must include a completed and signed Waiver of Liability Statement.

    NOTE: There is no change to the JH Advantage MD participating provider payment dispute process, address, phone or fax number.

    For a Fast Appeal (Advantage MD)

    Phone: PPO: 877-293-5325; TTY users may call 711
    Fax: 1-855-206-9206

 
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