Contact Us
Provider Contacts
General ContactsGeneral Contacts
Provider Services | 1-800-682-9091 |
Behavioral Health: For children younger than 18 years of age | Children requiring Care Management assistance for behavioral problems or mental health issues should be directed to the State of New Jersey’s Children’s System of Care Program at 1-877-652-7624. Staff is available 24 hours a day, seven days a week. DDD, MLTSS and FIDE-SNP members can call our Member Services for assistance. |
Behavioral Health: For adults 18 years and older | The NJ Mental Health Cares Program, New Jersey’s mental health information and referral service, is available during normal business hours at 1-866-202-4357. Hotline staff will refer members to community mental health programs throughout the State of New Jersey. DDD, MLTSS and FIDE-SNP members can call our Member Services for assistance. Members not enrolled with DDD, MLTSS or FIDE-SNP should call their local Medical Assistance Customer Center (MACC) for mental health services. To find the number of a local MACC, call the NJ FamilyCare hotline toll free at 1-800-701-0710 (TTY 711). |
Behavioral Health: After Hours | Member may call the State of New Jersey’s 211 program toll free at 1-877-652-1148 (TTY 711), 24 hours a day, seven days a week. |
Care, Case & Disease Management | 1-800-682-9094 x89385 Type of Calls
Division of Child Protection and Permanency (DCPP): 1-800-682-9094 x89907 Care/Case and Disease Management: 1-800-682-9094 x89634 Type of Member
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Consent for Sterilization | A Family Planning Prior Authorization Request form and a HHS-687 Consent for Sterilization Form must be completed and signed by the member in advance of a sterilization procedures being performed. We require that all Consent for Sterilization Forms be submitted to its Health Services Department by faxing the form to 1-609-583-3047 at least 30 days in advance of the procedure. |
Davis Vision | 1-800-933-9371 |
Discharge Planning | 1-800-682-9094 x89347; Fax: 1-609-583-3029 |
eviCore | 1-866-496-6200 |
Horizon NJ Health Care/Case Manager To speak with a Care/Case Manager or learn about a Disease Management Program |
1-800-682-9094 (TTY 711) |
Horizon NJ Health Enrollment Hotline For information on enrollment |
1-800-637-2997 |
LabCorp | 1-800-631-5250 |
ModivCare (Transportation) | 1-866-527-9933 (TTY 1-866-288-3133) |
Managed Long Term Services & Supports (MLTSS) Member Services | 1-844-444-4410 (TTY 711) |
MLTSS Claim Inquiries | Email: MLTSS_Provider@HorizonBlue.com |
MLTSS Provider Services | 1-855-777-0123 |
Member Services Someone is available 24 hours a day, seven days a week to help you |
1-800-682-9090 (TTY 711) |
NaviNet Customer Care | 1-888-482-8057 |
New Jersey State Health Benefits Coordinator (HBC) For questions about the status of your application |
1-800-701-0710 (TTY 1-800-701-0720) |
Pharmacy Department | 1-800-682-9094 |
SKYGEN USA Dental Provider Services | 1-855-878-5368 |
Network Relations AssignmentsNetwork Relations Assignments
MEDICAL PROFESSIONAL PRACTITIONERS/PRACTICES
Network Specialist | County Assignment |
Jill Clark 1-973-466-4831 |
Burlington (covering) Essex Hudson Passaic (covering) |
Loveann Cranshaw 1-856-638-3117 |
Atlantic Cape May Cumberland Gloucester (covering) Salem |
Lori Ditzel 1-732-256-5960 |
Ocean |
Maureen Hanson 1-609-537-2152 |
Camden (covering) Middlesex Union |
Kathleen Hollinghurst
1-973-466-7781 |
Hunterdon Mercer Monmouth (covering) Somerset |
William Mitchell 1-609-537-2596 |
Bergen (covering) Morris Sussex Warren |
BEHAVIORAL HEALTH PROFESSIONAL PRACTITIONERS/PRACTICES
Network Specialists | County Assignment |
Dottie Laisi 1-856-638-3215 Dorothy_Laisi@HorizonBlue.com |
Atlantic Cape May Cumberland Gloucester Monmouth Ocean |
Michelle McCusker 1-856-638-3223 Michelle_McCusker@HorizonBlue.com |
Burlington Camden Middlesex Salem |
Olivia Inniss 1-973-466-4609 Olivia_Inniss@HorizonBlue.com |
Bergen Essex Hudson Passaic |
LaTanya McLean Barkley 1-856-638-3228 LaTanya_Barkley@HorizonBlue.com |
Hunterdon Mercer Morris Somerset Sussex Union Warren |
MEDICAL ANCILLARY PROVIDERS/FACILITIES
Provider Contracting Contact | Specialties | |
Alana McDonald 1-609-537-2438 Alana_McDonald@HorizonBlue.com |
Adult Family Care* Adult Medical Day Care/ Pediatric Medical Day Care Caregiver Participant Training* Chore Service (Cleaning/Maintenance)* Cognitive Therapy* Community Residential Services* Community Transition Services* Home Delivered Meals* Medication Dispensing* Non-Medical Transportation* Personal Emergency Response System (PERS)* Residential/Vehicle Modification* Social Adult Day* Traumatic Brain Injury (TBI)* Radiology |
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Denice Berrios 1-609-537-2446 Denice_Berrios@HorizonBlue.com |
Assisted Living Program* Assisted Living Residence* Comprehensive Personal Care Home* Skilled Nursing Facility* Sub Acute Rehab Comprehensive Outpatient Rehab Facility (CORF) Laboratory Sleep Studies |
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Stephen Fitch 1-609-537-2614 Stephen_Fitch@HorizonBlue.com |
Electronic Visit Verification (EVV) Ambulatory Surgical Center (ASC) Lithotripsy |
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Walgena Daniels 1-609-537-2335 Walgena_Daniels@HorizonBlue.com |
Dialysis Hearing (Audiology) Orthotic & Prosthetic (O&P) Durable Medical Equipment (DME) Home Infusion PT/OT/ST (outpatient) |
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Lori Bembry 1-609-537-2427 Lori_Bembry@HorizonBlue.com |
Ambulance (Transportation) Home-Based Supportive Care* Home Health Hospice Personal Care Assistant (PCA) Private Duty Nursing Respite (In-Home)* |
* Denotes MLTSS Services
BEHAVIORAL HEALTH ANCILLARY PROVIDERS/FACILITIES
Ancillary Contracting Specialists | County |
Andrew Alleman 1-973-466-6824 Andrew_Alleman@HorizonBlue.com |
Bergen Cumberland Essex Hudson Monmouth Morris Passaic Somerset Sussex Union Warren |
David Ferguson 1-973-466-7220 David_Ferguson@HorizonBlue.com |
Atlantic Burlington Camden Cape May Gloucester Hunterdon Mercer Middlesex Ocean Salem |
Claims and AppealsClaims and Appeals
Claims | Claims and other billing forms should be submitted to: Horizon NJ Health Claims Processing Department P.O. Box 24078 Newark, NJ 07101-0406 |
Dental Claims Inquiries | Dental claims should be submitted to: Horizon NJ Health PO Box 299 Milwaukee, WI 53201 Call: 1-855-878-5368 Visit: SKYGENUSA.com |
Utilization Management Appeals | Utilization Management decisions appeals should be submitted to: Horizon Medical Appeals PO Box 10194 Newark, NJ 07101 Or Fax to 1-609-583-3028 You can also request an appeal by calling the UM Appeals Department at 1-800-682-9094, ext. 9606, prompt 2. |
Administrative Claim Appeals | Administrative Claim Appeals should be submitted to: Horizon NJ Health Administrative Claim Appeals PO Box 63000 Newark, NJ 07101 Or Fax to 1-973-522-4678 |
For questions regarding billing or appeals, please contact the Physician and Health Care Hotline at 1-800-682-9091 and/or your Professional Relations Representative.
Changes to Your PracticeChanges to Your Practice
It is very important that Horizon NJ Health maintains
accurate information in our provider database. This information is essential for providing access to
services for our members.
It is each practice’s responsibility to notify Horizon NJ
Health 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 a
provider death, the practice should notify Horizon NJ Health immediately.
You can email demographic information updates to EnterprisePDM@HorizonBlue.com or mail to:
Horizon BCBSNJ Provider Files
3 Penn Plaza East, PP-14C
Newark, NJ 07105-2200
Horizon BCBSNJ Provider Files
3 Penn Plaza East, PP-14C
Newark, NJ 07105-2200
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
with return receipt to:
Horizon NJ Health
1700 American Blvd
Pennington, NJ 08534
Attention: Network Relations
1700 American Blvd
Pennington, NJ 08534
Attention: Network Relations
If you have any questions about this requirement, please
contact your Provider Relations Representative.
Click here for complete details on Demographic Updates.
AuthorizationsAuthorizations
Service | Contact | Authorization Type |
Inpatient | 1-800-682-9094 x81024 |
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Outpatient Facility Office Based | 1-800-682-9094 x81023 |
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Home Services | 1-800-682-9094 x81025 |
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Medical Day Care | 1-800-682-9094 x81364 Fax: 1-609-583-3048 |
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Personal Care Assistance | 1-800-682-9094 x81364 Fax: 1-609-583-3048 |
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Durable Medical Equipment & Medical Supplies | 1-800-682-9094 x81017 |
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Facility PT/OT/ST | 1-800-682-9094 x81623 | |
Personal Preference Program (PPP) | 1-855-465-4777 |
Community ResourcesCommunity Resources
Resource | Service and Contact |
2-1-1 | Educate members on the benefits of dialing 2-1-1 on a telephone, 24 hours a day, seven days a week, to be connected to social service programs and crisis intervention hotlines. |
Adult Protective Services (APS) | 1-800-792-8820, or NJ EASE 1-877-222-3737 |
New Jersey Division of Developmental Disabilities (DDD) | 1-800-832-9173 DDD determines those who are eligible to receive services it funds through its application process. Generally, to receive services, you must show that you have a severe, chronic physical and/or mental impairment that:
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Division of Child Protection and Permanency (formerly DYFS) | To report child abuse or neglect: 1-877-NJ ABUSE (652-2873) |