- Adolescent Risk Behaviors and Depression PIP Handbook
- Advance Directives
- ASAM Criteria for Patients and Families
- 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
- 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
- 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
- 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
- MLTSS Bed Type Revenue Codes
- Well-Being Screening Tool
- FAQ for MUE Notification
- MUE Rule Notification Letter Medicaid