Noncompliant members

Contact Member Services when a member does not abide by the member responsibilities, continues with disruptive behavior at the provider’s practice or refuses to comply with the recommended treatment program. Member Services will contact the member to discuss his or her responsibilities as a Horizon NJ Health member and seek to find a resolution to the situation.

Member Services: 1-800-682-9090 (TTY 711), 24 hours, seven days a week

A healthy relationship between a provider and a member is important. If the provider believes that he or she cannot have a healthy relationship with a member, the provider may ask that the member receive treatment from another provider. Other circumstances in which a provider may request that a member be changed to another provider include:

  • Inability to solve conflicts between the member and his or her dentist
  • If a member fails to comply with oral health care instructions, where such non-compliance prevents the dentist from safely or ethically proceeding with the member’s oral health care services
  • If a member has taken legal action against the provider