For Providers

Updates and Announcements

Guidelines for CMS 1500 Claim Form Submissions

Posted By Admin on October 08, 2014

Please be advised that, on April 1, 2014, Medicare stopped accepting the 8/5 CMS 1500 claim form and now only accepts form version 02/12.

Claims Processing for IUDs, Mirena and Other Contraceptive Devices

Posted By Admin on October 01, 2014
Tags: IUDs, Mirena

Please be advised that claims for the insertion and removal of IUDs, Mirena and other contraceptive devices are to adhere to the following rules

Vaccines for Children (VFC) Program Changes

Posted By NJHealth on September 12, 2014
Tags: VFC

Effective July 1, 2014, the Vaccines for Children (VFC) program no longer provides vaccines for members enrolled in NJ FamilyCare Plans B, C, and D. 

NaviNet Pended Claims Web Notice

Posted By NJHealth on September 11, 2014

We have been receiving inquiries about claims in NaviNet that are shown to be in pended status. We want to remind you that claims in pended status have not yet been processed.

List of Pre-Authorization Codes Fulfilled by NIA

Posted By NJHealth on August 27, 2014

National Imaging Associates (NIA) provides pre-authorizations on behalf of Horizon NJ Health for a select group of codes.

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