For Providers

Claims Information

Electronic Funds Transfer
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Horizon NJ Health encourages all hospitals, physicians and health care professionals to submit claims electronically. For those interested in electronic claim filing, please call TriZetto Trading Partners Solutions (TTPS) at 1-800-556-2231 Monday to Friday from
7 a.m. to 6 p.m CST or email to obtain more information. For more information on EDI, review Section 9.3, Procedures for Electronic Submission--Electronic Data Interchange in the Physician and Health Care Professional Manual.

Electronic Data (EDI) allows faster, more efficient and cost-effective claim submission for hospitals, physicians and health care professionals EDI, performed in accordance with nationally recognized standards, supports the industry´s efforts to reduce overhead administrative costs.

The benefits of billing electronically include:

  • Reduction of overhead and administrative costs
    • EDI eliminates the need for paper claims submission. It has also been proven to reduce claim re-work (adjustments).
  • Receipt of reports as proof of claim receipt
    • This makes it easier to tract the status of claims.
  • Faster transaction time for claims submitted electronically
    • An EDI claim averages about 24 to 48 hours from the time it is sent to the time it is received. This enables providers to easily track their claims.
  • Validation of data elements on the claim
    • By the time a claim is successfully received electronically, information needed for processing is present. This reduces the chance of data entry errors that occur when completing paper claim forms.
  • Quicker claim completion
    • Claims that do not need additional investigation are generally processed quicker. Reports have shown that a large percentage of EDI claims are processed within 10 to 15 days of their receipt.

Should you have questions regarding billing, please contact Physician and Health Care Hotline at 1-800-682-9091 and/or your Professional Relations Representative.