Resources & Guidelines
Find helpful resources and guidelines for all of our health plans.
Advantage MD
Employer Health Programs (EHP)
Priority Partners
US Family Health Plan (USFHP)
Join the Johns Hopkins Health Plans Network or Make Demographic Changes
- I’m interested in a NEW contract with Johns Hopkins Health Plans or I want to add another health plan to my contract
- Complete the online request form
- Do NOT fill out this form if you are adding a new provider to an already contracted provider group or requesting a change to the demographics (address, phone number, NPI, individual name change) of an already contracted provider.
- I’m already contracted and need to make demographic updates or add a provider to my group
- Please complete the online request form or send your request to [email protected]. Ensure you provide accurate information regarding the changes needed.
If you have any questions or need assistance contact our Provider Relations Customer Service at 888-895-4998 (option 4) or 410-762-5385.
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- Anesthesia Guidelines
- Care Management Programs
- CareLink
- Claims Retraction
- Clinical Practice Guidelines Policy
- Criteria for Practitioner Participation
- Emergency Department Review Process
- Medical Record Documentation Standards
- Quality Measures Tip Sheet
- Ongoing Monitoring State Fed Exclusion Debarment Sanctions Policy
- Preauthorization Criteria for Outpatient Specialty Services at Kennedy Krieger Institute
- Preventive Health Guidelines Policy
- Standard of Conduct
- Substance Abuse Assessment Tool (CAGE)**
- Sudden and Serious Diagnosis Codes
- Utilization Management Medical Polices
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- New Network Request Form
- Home Care Authorization Request Form
- Maryland Uniform Consultation Referral
- Maryland Uniform Credentialing
- Practitioner Office Site Evaluation Form
- Prospective Review
- Provider Update Form
- Provider Update Form (Online)
- Request for Medical Appropriateness Determination for Psychological Testing
- Uniform Treatment Plan
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- HMO Quick Reference Guide
- HMO Select Quick Reference Guide
- Mail Order Best Practices
- Medical Injectables Requiring NovoLogix Prior Authorization
- PPO Quick Reference Guide
- Practitioner Discipline & Appeals
- Termination of Network Participation, Reporting Terminations, Fraud & Abuse
- Yearly Wellness Checklist
- Offshore Attestation
- eviCore Laboratory Management Program
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- Outpatient Code Editor - Medicaid
- Radiology and Advanced Cardiac Imaging Codes Requiring Prior Authorization by eviCore
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
- Molecular and Genetic Testing Codes Requiring Preauthorization by eviCore
- Get Vaccinated Flyer
- Laboratory Policy
- Maryland Healthy Kids Preventive Health Screening Resources
- Medical Injectables Requiring Preauthorization
- Primary Care Quality & Efficiency Standards for Healthcare Quality Improvement
- Provider Appeals Policy
- Quick Reference Guide
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Note on Medical Record Standards Documentation: Johns Hopkins Health Plans has established standards for primary care medical record documentation. Records must be maintained in a manner that is current, detailed and organized to facilitated communication, coordination and continuity of care. The standards address confidentiality, the availability of the medical record, and required content of the record. To ensure confidential care for members, the Johns Hopkins Health Plans standards state that medical records are stored securely. Records must be easy to retrieve, but only authorized personnel should have access to them. In addition, staff is expected to receive training in member confidentiality. Compliance with these new standards will be monitored as part of our Quality Improvement Program.
Drug and alcohol abuse or dependence are common issues but are often under recognized in primary care settings. Utilizing a simple screening tool, such as the four question CAGE substance abuse assessment, is an easy yet effective way for the primary care provider to determine if substance abuse exists and needs to be addressed.