Cost & Quality Guidance

Members can now call J.P. Farley’s advocates to obtain both cost and quality information.

This service provides much more extensive assistance than required under the federal guidelines in both the number of services we will obtain pricing for as well as quality data, when applicable.

Call 800-634-0173 and select option 3 for Cost & Quality Guidance.

Access MRFs

PROVIDER
RESOURCES



At J.P. Farley, our goal is for health plans to work better for everyone – and that means making your job easier in every way we can. We’re committed to providing convenient provider resources that help you serve your J.P. Farley patients with ease.

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About ID Cards

J.P. Farley Corporation provides plan administration for a wide variety of self-funded health plans. This makes it critical for providers to reference the information provided on each participant’s ID Card.

  • Obtain a copy of the participant’s ID Card
  • Follow the instructions on the ID Card to obtain member eligibility, accumulators, etc.
  • Or register for online access to all relevant information, available 24/7, through our online Provider Portal

About Claim Submission

More specific information for claim submission, such as electronic payor IDs, may be found on participant ID Cards as well as within the online Provider Portal. This information is intended to provide a general overview of the claims submission process with J.P. Farley.

  • Claim must include Group Number, Unique Identification Number or Insured’s Social Security Number
  • The Provider must complete the provider portion of the form
  • For Plan reimbursement, attach bills for services rendered
  • Send to Claims Administrator at the electronic or mailing address listed on the summary of benefits or ID Card

For more information on how to file a claim

Click Here

The Provider Portal

Your Provider Portal from J.P. Farley empowers you with everything you need to manage patients and payments under our programs.

  • Submit real-time preauthorization and claim requests
  • Access eligibility information and claim status anytime
  • Download EOBs and provider claim & check reports
  • Provide clinical follow-up on a pre-certification
  • And more!

First-Time Users: Please call 800.634.0173 and follow the prompts to speak with a service team member to obtain a registration code and portal access.

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For benefit verification, claim status, explanation of payment or pre-certification:

Provider Resource Forms

  • W9
  • Precertification
  • Direct Contract
  • File a claim
  • How to Read an ID Card

W9

Request for Taxpayer Identification Number and Certification.

download PDF

Precertification

For use in the precertification of plan services as defined by the plan document. Please check plan member’s ID cards and follow the precert instructions on the ID Card. When calling J.P. Farley for precertification follow the phone prompts. Some networks require precertification through their own departments.

Download PDF

Direct Contract

Providers who want to enter into a formal direct contracting agreement may submit this form to J.P. Farley's contracting department.

download PDF

File a Claim

Reference what is needed to file a claim. Both the participant’s ID Card and the verification process provides more specific information, including the electronic payor id, needed for submitting claims for payment.

How to File a Claim

How to Read an ID Card

A reference providing an overview of what information can be accessed from the plan ID Card.

download PDF
  • W9
  • Request for Taxpayer Identification Number and Certification.

    download PDF
  • Precertification
  • For use in the precertification of plan services as defined by the plan document. Please check plan member’s ID cards and follow the precert instructions on the ID Card. When calling J.P. Farley for precertification follow the phone prompts. Some networks require precertification through their own departments.

    Call Us & Follow Precert Prompts
  • Direct Contract
  • Providers who want to enter into a formal direct contracting agreement may submit this form to J.P. Farley's contracting department.

    download PDF
  • File a Claim
  • Reference what is needed to file a claim. Both the participant’s ID Card and the verification process provides more specific information, including the electronic payor id, needed for submitting claims for payment.

    download PDF
  • How to Read an ID Card
  • A reference providing an overview of what information can be accessed from the plan ID Card.

    download PDF

If you can’t find what you need, contact us! We’re happy to help.