• OBAT modifier HF must be entered in the primary modifier field of the claim.


• Additional configuration is needed after you become credentialed. We ask that you do not submit claims until we notify you that you have been linked to the OBAT rates.


• We encourage all hospitals, physicians and health care professionals to submit claims electronically. We use the TriZetto Provider Solutions Direct Data Entry SimpleClaim system.

  All providers that previously used Emdeon to directly enter their claims must switch to the SimpleClaim system.

  More information on registering is available from TriZetto. If you have need help registering, please call Trizetto at 1-800-556-2231 or email ttpssupport@cognizant.com.

  We strongly encourage submitting claims via SimpleClaim. If a paper claim is necessary, please submit red and white paper claims, only for medical services, to:

  Horizon NJ Health Claims Processing Department
  PO Box 24078
  Newark, NJ 07101-0406

• Traditional outpatient therapy services (outside of OBAT) for core Medicaid members should be billed to the state as Fee-for-Service.


• Training is available. Our Network Teams hold monthly New Practitioner Orientations. These sessions provide an overview of the information every office should know to help in your day-to-day interactions with us. We strongly encourage you to register for one of these sessions:
  • Behavioral Health Providers
  • Physical Health Providers

Please call Provider Services at 1-800-682-9091 with any questions.