Timely Filing Requirements

Claims must be submitted within 180 calendar days from the date of service. The claim will be denied if not received within the required time frames.

Corrected claims must be submitted within 365 days from the date of service. Read more about how to file a corrected claim.

For retracted claims (claims submitted and paid, but retracted through HCAPP), if the corrected claim is received within 60 days from the date of the retraction, it will bypass timely filing. Corrected claim must be submitted with the appropriate resubmission code. Read more about how to file a corrected claim.

Coordination of Benefits (COB) claims must be submitted within 60 days from the date of primary insurer’s Explanation of Benefits (EOB) or 180 days from the dates of service, whichever is later.

If you have questions regarding billing, contact Provider Services at 1-800-682-9091 and/or your Provider Representative.

Claim Overpayment: Payment Return Policy

The Affordable Care Act requires providers to report and return overpayments to Horizon NJ Health within 60 days of self-identifying the overpayment.

Instructions for reporting/returning overpayments

Please send details of the overpayment, including a check written to ‘Horizon NJ Health’ and the claim ID(s), to:

  • Horizon NJ Health
  • Claims Services
  • PO Box 24077
  • Newark, NJ 07101-0406

If you have any questions, please call Provider Services at 1-800-862-9091, weekdays, from 8 a.m. to 5 p.m.