Claims Addresses

Referral Forms, Claims and other billing forms should be submitted to:

Horizon NJ Health
Claims Processing Department
P.O. Box 24078
Newark, NJ 07101-0406

Appeals Addresses

Utilization Management Decisions Appeals should be submitted to:

Horizon NJ Health
Appeals Department
210 Silvia Street
West Trenton, NJ 08628

Family Planning Related Appeals should be submitted to:

Horizon NJ Health
Appeals Department
210 Silvia Street
West Trenton, NJ 08628

Administrative Claim Appeals should be submitted to:

Horizon NJ Health
Administrative Claim Appeals
PO Box 63000
Newark, NJ 07101
Or
Fax: 1-973-522-4678

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

It is very important that Horizon NJ Health maintains accurate information in our provider database. This information is essential in providing access to services for the Medicaid/NJ FamilyCare population that we all serve.

It is each Practice’s responsibility to notify Horizon NJ Health 90 days prior to any change in the status of the practice or provider. This includes the sale or purchase of a practice, the addition of a provider or the retirement of a provider. In the case of death, the practice should notify Horizon NJ Health immediately.

You can email demographic information updates to ProviderFileOps2@horizonblue.com or fax to 973-274-4126. Please note that this email address and fax number are to be used for initial requests only; all other inquiries may be made through your Horizon NJ Health provider representative. Click here for a list of provider representatives.

The reference guide found here explains the requirements and documentation needed for each type of change. Please provide a letter outlining your request along with required documentation 30 days prior to the effective date of the requested change(s).

If you are terminating from the network, you are required to send a notice via certified mail, as per your agreement. Please send notification via certified mail, return receipt to:

Horizon NJ Health
210 Silvia Street
West Trenton, NJ  08628
Attention: Sandra Walters-Muschett, Manager, Network Operations & Contracting

If you have any questions about this requirement, please contact your Professional Relations Representative at 1-800-682-9094.