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        • Modifier JW – Drug WasteModifier JW – Drug Waste
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        • Pulmonary Diagnostic Procedures when billed with Evaluation and Management CodesPulmonary Diagnostic Procedures when billed with Evaluation and Management Codes
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    • Adolescent Risk Behaviors and Depression PIP Handbook

      Advance Directives

      ASAM Criteria for Patients and Families

      Clinical and Preventive Guidelines

      Credentialing and Recredentialing Responsibilities

      Cultural Competency

      Demographic updates

      Educational Material for Providers

      Forms

      Guides

      Health Literacy

      Horizon NJ Health Taxonomy Code Information

      ICD-10

      Laboratory Corporation of America (LabCorp)

      Medicaid Reimbursement and Billing

      MLTSS Non-Medical Professional Provider Manual

      MLTSS Orientation

      National Imaging Associates

      NJ Addiction Services Hotline

      Pharmacy Utilization Management Programs

      Policies

      Provider Newsletter

      Provider Manual

      State of New Jersey Contractual Requirements

      Timely Filing Requirements

      Utilization Management

      MLTSS Bed Type Revenue Codes

      Well-Being Screening Tool

      FAQ for MUE Notification

      MUE Rule Notification Letter Medicaid

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      • For Providers: 1-800-682-9091
    • Dental

      Disease Management Programs to Help Your Patients

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      Fluoride Varnish Pediatric Application

      Focus on Risk Adjustment

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      Horizon NJ TotalCare (HMO D-SNP)

      Managed Long Term Services and Supports

      Mom's GEMS Prenatal Program

      Office Based Addiction Treatment (OBAT) Program

      Primary Care Physician Program

      Quality Improvement Program

  • Provider Recruitment
      • For Providers: 1-800-682-9091
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Provider Newsletter - Horizon NJ Health

  1. Home
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  4. ›Provider Newsletter
Adolescent Risk Behaviors and Depression PIP Handbook
Advance Directives
ASAM Criteria for Patients and Families
Clinical and Preventive GuidelinesClinical and Preventive Guidelines
Clinical Guidelines
Credentialing and Recredentialing ResponsibilitiesCredentialing and Recredentialing Responsibilities
Credentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals
Credentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) Providers
Cultural Competency
Demographic updates
Educational Material for ProvidersEducational Material for Providers
ClaimsXTen FAQs
ClaimsXTen Edit Codes and Messages
CareAffiliate Training
SimpleClaim Training Resources
How to Correctly Submit Claims with J or Q Codes
FormsForms
Age - Appropriate EPSDT Forms
Forms
Nurse Practitioner
Physician Assistant
Physician
Ancillary Provider
Physical Therapist, Occupational Therapist, Speech Therapist
Electronic Funds Transfer (EFT) Forms
Clinical Authorization Forms
Lead Risk Assessment
Guides
Health LiteracyHealth Literacy
Resource Links
Tips and Tools
Horizon NJ Health Taxonomy Code Information
ICD-10
Laboratory Corporation of America (LabCorp)Laboratory Corporation of America (LabCorp)
LabCorp Alert and Panic Results Policy
LabCorp Connectivity Solutions
LabCorp introduces RoadNet®
LabCorp BeaconTM: Patient
NuSwab: Candida and STD testing
Medicaid Reimbursement and BillingMedicaid Reimbursement and Billing
Medicaid Provider Enrollment Requirements by State
Horizon NJ Health Foot Orthotic Shoes and Inserts Reimbursement Policy
MLTSS Non-Medical Professional Provider Manual
MLTSS Orientation
National Imaging Associates
NJ Addiction Services Hotline
Pharmacy Utilization Management ProgramsPharmacy Utilization Management Programs
Pharmacy Medical Necessity Determination
Maximum Allowable Cost (MAC) Appeal Form
PoliciesPolicies
Medical Policies
Reimbursement Policies & Guidelines Reimbursement Policies & Guidelines
Allergy Immunotherapy
Ambulance Services
Billing Requirements for Clinical Trials
Chiropractic Manipulation Diagnosis Policy
Claim Editing Policy
Daily Maximum Units for Surgical Pathology and Microscopic Examination
Diabetic Screening Services
Evaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo or Myocardial Profusion Imaging
Foot Orthotic Shoes and Inserts
Frequency of Ocular Photography
Laboratory Services Billed by Physicians
Maximum Units Policy on Hearing Aid Batteries
Modifier JW – Drug Waste
Modifier 22 – Increased Procedural Services
Modifier 50 – Bilateral and LT/RT
Modifier 52 – Reduced Services
Modifier 53 – Discontinued Procedures
Modifier 54 – Surgical Care Only
Modifier 55 – Postoperative Management Only
Modifier 56 – Preoperative Management Only
Modifier 57 – Decision for Surgery
Modifier 62 – Two Surgeons
Modifier 66- Surgical Team
Modifier 76- Repeat Procedure or Service by Same Physician
Modifier 77- Repeat Procedure or Service by Another Physician
Modifier 78 – Unplanned Return to the OR
Modifiers 80, 81, 82 and AS – Assistant Surgeon
Multiple Procedure Reduction
Multiple Procedure Payment Reduction for Endoscopies
Mutually and Non-Mutually Exclusive NCCI Edits
Preventative Medicine Services with Auditory Screening
Pulmonary Diagnostic Procedures when billed with Evaluation and Management Codes
Readmission Policy (Medicaid)
Readmission Policy (Medicaid) – FAQ
Telemedicine and Telehealth
Ulcer Debridement and Ulcer Stages
Health Services Policies – Clinical Affairs, Dental, Pharmacy, Quality, Utilization Management
Provider Newsletter
Provider Manual
State of New Jersey Contractual Requirements
Timely Filing RequirementsTimely Filing Requirements
Billing Guide
Electronic Data Interchange (EDI)/Electronic Funds Transfer (EFT)
Emdeon Electronic Funds Transfer (EFT) Forms
Claims Addresses
ClaimsXTen FAQs
Tips for Claims/Encounters Filing
NIA Claims Matrix
False Claims Policy
Utilization ManagementUtilization Management
Precertification Reference List
Utilization Management Appeal Process for Administrative Denials
MLTSS Bed Type Revenue Codes
Well-Being Screening Tool
FAQ for MUE Notification
MUE Rule Notification Letter Medicaid

Provider Newsletter

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Pdf ImageHorizon Pulse 2019, Issue 1  

Pdf ImageHorizon Pulse 2018, Issue 3  

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Pdf ImageProviderLink 2017, Issue 4  

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Pdf ImageProviderLink 2016, Issue 4  

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Pdf ImageProviderLink 2015, Issue 4  

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