Frequently Asked Questions
JPG is a one stop shop for all things credentialing. By having an IPA, you complete one application and we take care of the rest, allowing you to focus on what you do best: taking care of patients!
JPG’s responsibilities extend beyond enrollment and obtaining effective dates for health plans. The carriers require us to conduct ongoing monitoring of sanctions, NPDB, and other relevant checks, and provide them with regular reports. This continuous oversight is vital to ensure you maintain uninterrupted health plan enrollment and avoid any disruption in your revenue flow. In addition to this ongoing monitoring, we also undergo extensive annual audits by health plans.
Every three years, we re-credential our members to comply with regulatory requirements. This process includes primary source verification of credentials, ensuring that all physicians’ qualifications, such as malpractice insurance, DEA, licenses, and more, are current.
Jefferson Physician Group offers two types of memberships.
Credentialed Membership:
Credentialing for primary care & specialists
Contracting
Group Purchasing Discounts
Vaccine Discounts
Networking & Referrals
Access to meetings and events
Networking Membership:
For primary care & specialists
Group Purchasing Discounts
Vaccine Discounts
Networking & Referrals
Access to meetings and events
For more information click JOIN
The initial application turnaround time is approximately 3–4 weeks and is entirely dependent on the completeness of the provider's application.
1. Application Submission: The provider submits the required documentation to the credentialing team. It is crucial that the application is complete and accurate to avoid any delays.
2. Verifications: The credentialing team reviews the application and conducts Primary Source Verifications in accordance with CMS, NCQA, and insurance carrier standards.
3. Board Approval: Once the application is complete and signed off by the credentialing team, it is submitted to the Jefferson Physician Group Board for approval. *The initial application turnaround time is approximately 3–4 weeks and is entirely dependent on the completeness of the provider's application. Incomplete applications will be rejected.
4. Insurance Submission: Once board approval is received, the provider will be submitted to the selected insurance carriers for loading. The insurance carriers can take approximately 90–180 business days to fully load a provider. The insurance carrier decides the effective date and can backdate it, but this is NOT a guarantee.
We have contracts with all major carriers. You get to chose which contracts are best for you.
ACPN, Aetna, BCBSTX, Cigna, Evry, Galaxy, HealthSmart, Humana, Imperial, IMS, Molina, MultiPlan/PHCS, Oscar, Zelis (NPPN), Prime Health, PSI, USA, *UHC.
*Please see the next section regarding UHC
United Healthcare's policy only allows IPAs to hold the delegated credentialing portion of a contract. The provider holds their own contract with UHC. Jefferson Physician Group ONLY handles credentials verification and ongoing monitoring.
All questions and concerns regarding UHC contracting must be directed to Michelle Antisdel at michelle_antisdel@uhc.com or 952-202-7101 or through the UHC provider portal. JPG does not have access to provider contracts and is unable to answer any contracting questions.
Fee Schedule Lookup Quick Start Guide
Need support for UHC provider portal, claims, prior authorization or eligibility and benefits? Sign into the UnitedHealthcare Provider Portal to chat with a UHC service advocate.
Need help with contracting? Use your One Healthcare ID to access Network Help and Support and chat with an advocate.