- Adolescent Risk Behaviors and Depression PIP Handbook
- Advance Directives
- ASAM Criteria for Patients and Families
- Balance Billing for FIDE-SNP Members
- 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
- Clinical and Preventive GuidelinesClinical and Preventive 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
- DSNP Cognitive Impairment for Providers
- Educational Material for ProvidersEducational Material for Providers
- ClaimsXTen FAQs
- ClaimsXTen Edit Codes and Messages
- PT/OT Prior Authorization Program Presentation
- CareAffiliate Training
- SimpleClaim Training Resources
- Transitioning for a Better Provider Experience
- How to Correctly Submit Claims with J or Q Codes
- FormsForms
- Forms
- Additional Application Forms
- Age - Appropriate EPSDT Forms
- Electronic Funds Transfer (EFT) Forms
- Clinical Authorization Forms
- Lead Risk Assessment
- Guides
- Health LiteracyHealth Literacy
- 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
- PoliciesPolicies
- Medical Policies
- Reimbursement Policies & Guidelines Reimbursement Policies & Guidelines
- Allergy Immunotherapy
- Ambulance Services
- Foot Orthotic Shoes and Inserts
- 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 78 – Unplanned Return to the OR
- Modifiers 80, 81, 82 and AS – Assistant Surgeon
- Readmission Policy (Medicaid)
- Readmission Policy (Medicaid) – FAQ
- Health Services Policies – Clinical Affairs, Dental, Pharmacy, Quality, Utilization Management
- Provider Newsletter
- Provider Communications
- Provider Manual
- Scion Dental
- State of New Jersey Contractual Requirements
- Utilization ManagementUtilization Management
- Well-Being Screening Tool
Toggle menu
- BACKback to www.horizonblue.com
- PROVIDERS
-
ResourcesResources
- Resources
- Adolescent Risk Behaviors and Depression PIP HandbookAdolescent Risk Behaviors and Depression PIP Handbook
- Advance DirectivesAdvance Directives
- ASAM Criteria for Patients and FamiliesASAM Criteria for Patients and Families
- Balance Billing for FIDE-SNP MembersBalance Billing for FIDE-SNP Members
-
Timely Filing RequirementsTimely Filing Requirements
- Timely Filing Requirements
- Billing GuideBilling Guide
- Electronic Data Interchange (EDI)/Electronic Funds Transfer (EFT)Electronic Data Interchange (EDI)/Electronic Funds Transfer (EFT)
- Emdeon Electronic Funds Transfer (EFT) FormsEmdeon Electronic Funds Transfer (EFT) Forms
- Claims AddressesClaims Addresses
- ClaimsXTen FAQsClaimsXTen FAQs
- Tips for Claims/Encounters FilingTips for Claims/Encounters Filing
- NIA Claims MatrixNIA Claims Matrix
- False Claims PolicyFalse Claims Policy
- Clinical and Preventive GuidelinesClinical and Preventive Guidelines
-
Credentialing and Recredentialing ResponsibilitiesCredentialing and Recredentialing Responsibilities
- Credentialing and Recredentialing Responsibilities
- Credentialing and Recredentialing Policy for Participating Physicians and Healthcare ProfessionalsCredentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals
- Credentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) ProvidersCredentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) Providers
- Cultural CompetencyCultural Competency
- DSNP Cognitive Impairment for ProvidersDSNP Cognitive Impairment for Providers
-
Educational Material for ProvidersEducational Material for Providers
- Educational Material for Providers
- ClaimsXTen FAQsClaimsXTen FAQs
- ClaimsXTen Edit Codes and MessagesClaimsXTen Edit Codes and Messages
- PT/OT Prior Authorization Program PresentationPT/OT Prior Authorization Program Presentation
- CareAffiliate TrainingCareAffiliate Training
- SimpleClaim Training ResourcesSimpleClaim Training Resources
- Transitioning for a Better Provider ExperienceTransitioning for a Better Provider Experience
- How to Correctly Submit Claims with J or Q CodesHow to Correctly Submit Claims with J or Q Codes
-
FormsForms
- Forms
- FormsForms
- Additional Application FormsAdditional Application Forms
- Age - Appropriate EPSDT FormsAge - Appropriate EPSDT Forms
- Electronic Funds Transfer (EFT) FormsElectronic Funds Transfer (EFT) Forms
- Clinical Authorization FormsClinical Authorization Forms
- Lead Risk AssessmentLead Risk Assessment
- GuidesGuides
- Health LiteracyHealth Literacy
- Horizon NJ Health Taxonomy Code InformationHorizon NJ Health Taxonomy Code Information
- ICD-10ICD-10
-
Laboratory Corporation of America (LabCorp)Laboratory Corporation of America (LabCorp)
- Laboratory Corporation of America (LabCorp)
- LabCorp Alert and Panic Results PolicyLabCorp Alert and Panic Results Policy
- LabCorp Connectivity SolutionsLabCorp Connectivity Solutions
- LabCorp introduces RoadNet<sup>®</sup>LabCorp introduces RoadNet<sup>®</sup>
- LabCorp Beacon<sup>TM</sup>: PatientLabCorp Beacon<sup>TM</sup>: Patient
- NuSwab: Candida and STD testingNuSwab: Candida and STD testing
- Medicaid Reimbursement and BillingMedicaid Reimbursement and Billing
- MLTSS Non-Medical Professional Provider ManualMLTSS Non-Medical Professional Provider Manual
- MLTSS OrientationMLTSS Orientation
- National Imaging AssociatesNational Imaging Associates
- NJ Addiction Services HotlineNJ Addiction Services Hotline
- Pharmacy Utilization Management ProgramsPharmacy Utilization Management Programs
-
PoliciesPolicies
- Policies
- Medical PoliciesMedical Policies
-
Reimbursement Policies & GuidelinesReimbursement Policies & Guidelines
- Reimbursement Policies & Guidelines
- Allergy ImmunotherapyAllergy Immunotherapy
- Ambulance ServicesAmbulance Services
- Foot Orthotic Shoes and InsertsFoot Orthotic Shoes and Inserts
- Modifier 22 – Increased Procedural ServicesModifier 22 – Increased Procedural Services
- Modifier 50 – Bilateral and LT/RTModifier 50 – Bilateral and LT/RT
- Modifier 52 – Reduced ServicesModifier 52 – Reduced Services
- Modifier 53 – Discontinued ProceduresModifier 53 – Discontinued Procedures
- Modifier 54 – Surgical Care OnlyModifier 54 – Surgical Care Only
- Modifier 55 – Postoperative Management OnlyModifier 55 – Postoperative Management Only
- Modifier 56 – Preoperative Management OnlyModifier 56 – Preoperative Management Only
- Modifier 57 – Decision for SurgeryModifier 57 – Decision for Surgery
- Modifier 62 – Two SurgeonsModifier 62 – Two Surgeons
- Modifier 78 – Unplanned Return to the ORModifier 78 – Unplanned Return to the OR
- Modifiers 80, 81, 82 and AS – Assistant SurgeonModifiers 80, 81, 82 and AS – Assistant Surgeon
- Readmission Policy (Medicaid)Readmission Policy (Medicaid)
- Readmission Policy (Medicaid) – FAQReadmission Policy (Medicaid) – FAQ
- Health Services Policies – Clinical Affairs, Dental, Pharmacy, Quality, Utilization ManagementHealth Services Policies – Clinical Affairs, Dental, Pharmacy, Quality, Utilization Management
- Provider NewsletterProvider Newsletter
- Provider CommunicationsProvider Communications
- Provider ManualProvider Manual
- Scion DentalScion Dental
- State of New Jersey Contractual RequirementsState of New Jersey Contractual Requirements
- Utilization ManagementUtilization Management
- Well-Being Screening ToolWell-Being Screening Tool
-
ProgramsPrograms
- Programs
-
ACA Enhanced PCP Reimbursement PaymentsACA Enhanced PCP Reimbursement Payments
- ACA Enhanced PCP Reimbursement Payments
- ACA Reimbursement Payable CodesACA Reimbursement Payable Codes
- ACA Reimbursement Self-Attestation FormACA Reimbursement Self-Attestation Form
- ACA Reimbursement Group Attestation FormACA Reimbursement Group Attestation Form
- ACA Reimbursement Frequently Asked QuestionsACA Reimbursement Frequently Asked Questions
- ACA Reimbursement Remittance Advice DescriptionACA Reimbursement Remittance Advice Description
- Disease Management Programs to Help Your PatientsDisease Management Programs to Help Your Patients
- Education OpportunitiesEducation Opportunities
- Fluoride Varnish Pediatric ApplicationFluoride Varnish Pediatric Application
- Focus on Risk AdjustmentFocus on Risk Adjustment
- Horizon Behavioral HealthHorizon Behavioral Health
- Horizon NJ TotalCare (HMO SNP) Educational WebinarsHorizon NJ TotalCare (HMO SNP) Educational Webinars
- Managed Long Term Services and SupportsManaged Long Term Services and Supports
- Mom's GEMS Prenatal ProgramMom's GEMS Prenatal Program
- Office Based Addiction Treatment (OBAT) ProgramOffice Based Addiction Treatment (OBAT) Program
- Primary Care Physician ProgramPrimary Care Physician Program
-
Quality Improvement ProgramQuality Improvement Program
- Quality Improvement Program
- Results & Recognition ProgramResults & Recognition Program
- Smoking CessationSmoking Cessation
- HEDIS®HEDIS®
- CAHPS (Consumer Assessment of Healthcare Providers and Systems)CAHPS (Consumer Assessment of Healthcare Providers and Systems)
- Progress Toward HNJH’s GoalsProgress Toward HNJH’s Goals
- Hospital Acquired Conditions and Serious Adverse EventsHospital Acquired Conditions and Serious Adverse Events
- Provider RecruitmentProvider Recruitment
- NewsNews
- FIND A DOCTOR
- MEMBER SIGN IN
-
Resources
- For Providers: 1-800-682-9091
-
Programs
- For Providers: 1-800-682-9091
-
Provider Recruitment
- For Providers: 1-800-682-9091
-
News
- For Providers: 1-800-682-9091
Provider Newsletter - Horizon NJ Health
Horizon Pulse 2019, Issue 1Are you sure you want to leave this website?
You are leaving the Horizon NJ Health website. Please click Continue to leave this website. Or, if you would like to remain in the current site, click Cancel.