Horizon nj health dentists org; WHO. Choose from our nationwide network of participating For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) The approved prescription drugs that Horizon NJ Health covers make up our formulary. Communications may be issued by Horizon Blue Cross Blue Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. . The physician and dentist remains responsible for the quality and type of health care services provided to a Horizon NJ Health member. Our goal is for our members to get the right care, in the right setting, when they need it. Horizon NJ Health President and Chief Operating Officer Karen Clark named as one of the Top 25 Minority Health Executives in the Nation by Modern Healthcare Executive Magazine. 2005 Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Headquartered in West Trenton, NJ, Horizon NJ Health is wholly owned by Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. “Dental necessity” or “dentally necessary” means or describes a dental service that a dental care provider, exercising prudent clinical judgment, would provide to a covered person for the purpose of For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) The material provided by Horizon NJ Health is intended to be used as general information only and should not replace the advice of your physician. , each an independent licensee of the Blue Horizon NJ Health Care/Case Manager To speak with a Care/Case Manager or learn about a Disease Management Program: 1-800-682-9094 (TTY 711) Newark, NJ 07101-0406; Dental Claims Inquiries: Dental claims should be submitted to: Horizon NJ Health PO Box 299 Milwaukee, WI 53201 Call: 1-855-878-5368 For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) To view benefit information, look under the column in the NJ FamilyCare chart that matches the type of plan noted on your Horizon NJ Health ID card. 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. PCPs must refer members to a dental home by the age of 1. Services include preventive care, restorative care, extractions, and emergency dental care. If you did not select a PCP on your enrollment form, we will select one for you based on where you live and your Find Horizon NJ Health Dentists & Providers with verified reviews. Each level has . Prior authorization shall be conducted by a currently licensed New Jersey dentist, who is appropriately trained in the principles, procedures and standards of utilization review You can search for participating doctors or dentists by using our Doctor & Hospital Finder. Communications may be issued by Horizon Blue Cross Blue SKYGEN USA administers dental services for Horizon NJ Health members. Our family friendly dentists in Paramus, NJ specialize in your Oral health and beautiful smiles. Communications may be issued by Horizon Blue Cross Blue There are several ways to determine a member’s eligibility for benefits: Verify on Availity Essentials™. Make an appointment online instantly with Endodontists that accept Horizon NJ Health insurance. Make Aetna your choice during Retiree Dental enrollment which is open For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Find Care in NJ. Your PCP is the first source for your health care. Now, you can make an appointment with New Jersey’s largest dental insurer. , each an independent licensee of the Blue Cross Blue Shield DENTAL POLICY: Dental Continuity of Care Policy EFFECTIVE DATE: December 1, 2011 LAST REVIEWED DATE: June 12, 2024 LAST REVISED DATE: June 12, 2024 PURPOSE: The policy is to ensure our members are provided continuity of care when transferred from a different MCO to HNJH. Horizon Horizon NJ Health offers a full range of dental services to diagnostic, its members. This directory lists all providers in the Horizon NJ Health network. Can I go to a doctor or dentist who is not . Horizon NJ Health offers comprehensive dental services to NJ FamilyCare A, B, C, D and ABP members as well as to Managed Long Term Services & Supports and Horizon NJ TotalCare Use the Horizon NJ Health Provider Directory to find a doctor near you. , each an independent licensee of the Blue Cross Blue Shield Association. It's free! Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Use convenient online services to make eligibility and payment inquires, view claim status, access reference materials and more. For more information, please contact SKYGEN USA 1-855-878-5368. different benefits and copays. Since its inception in 1993, Horizon NJ Health has grown to more than 854,000 members and provides services in all 21 New Jersey counties. Member Services Someone is available 24 hours a day, seven days a week to help you, please call: 1-800-682-9090 (TTY 711) Horizon NJ Health Enrollment Hotline For information on enrollment, please call: 1-800-637-2997 . com; Credentialing. under your Horizon NJ Health plan, you must use a provider who participates with Horizon NJ Health. This directory provides demographic information about dental providers who treat members under the age of 6 years old. If your ID card does not list a plan, you receive NJ FamilyCare A or NJ FamilyCare ABP benefits. COVID-19 Information ; Coverage for Out-of-Network COVID-19 Testing Ending Coverage for Out-of-Network COVID-19 Testing Ending; Code Terminations as the PHE Ends Code Terminations as the PHE Ends; PHE Update: Prescription Limitation Change for Our Dental Services for Horizon NJ Health (Medicaid) Members: Preventative Dentistry: Emphasizing the importance of early oral hygiene with gentle cleanings, fluoride treatments, and dental sealants. Spanish (Español): Para ayuda en español, llame al 1-866-660-6528 (TTY 711). Discover the finest dentists near you at Aspen Dental, where exceptional care meets affordability. com |; Custom Directory |; Glossary |; Feedback. If you are a homebound member and you need special Horizon NJ Health is New Jersey's largest health care management company serving publicly insured individuals in the Medicaid and NJ FamilyCare programs. , each an independent licensee of the Blue Cross Blue Shield Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. Here’s how it works: • Visit HorizonBlue. Horizon Blue Cross Blue Shield of New Jersey · HorizonBlue. , each an independent licensee of the Blue Cross Blue Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. Communications may be issued by Horizon Blue Cross Blue Mobile Dental Practice (utilizing portable equipment) is a provider traveling to various locations and using portable dental equipment to provide dental services outside of a dental office/clinic in settings to include but not limited to facilities, schools and residences. Horizon NJ Health has a Medicare contract and a contract with the State of New Jersey Medicaid Program to offer Horizon NJ TotalCare (HMO D-SNP) an HMO Medicare Find Horizon NJ Health Endodontists & Providers with verified reviews. Providers may not New Jersey’s largest dental insurer. It may be provided a second time with SKYGEN USA administers dental services for Horizon NJ Health members and coordinates all precertification for the provision of inpatient dental care. For the most recent information or if you have other questions, please Find a Dentist in New Jersey | Horizon BCBSNJ. Find Care Outside NJ. Sam Wakim . ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Horizon NJ Health members receive a comprehensive dental benefit that includes oral exams, preventive services and treatment. com; PROVIDERS ; COVID-19 Information COVID-19 Information. If your doctor wants to prescribe a drug that is not included in our formulary, he or she will need to Claims Addresses Paper Claim Submissions: Horizon NJ Health Claims Processing Department PO Box 24078 Newark, NJ 07101-0406 Member/Provider Correspondence: Horizon NJ Health Member/Provider Correspondence PO Box 24077 Newark, NJ 07101-0406 Appeals Addresses SKYGEN USA administers dental services for Horizon NJ Health members and coordinates all precertification for the provision of inpatient dental care. and Horizon Blue Cross Blue Shield of New Jersey, both of which Health Dental Vision Here when you need us most. “Dental necessity” or “dentally necessary” Your Horizon NJ Health member ID card shows your benefit level. But if your Horizon NJ Health members present a digital member ID card, you must accept it based on our Digital Member ID Card Policy. Make an appointment online instantly with Dentists that accept Horizon NJ Health insurance. Horizon NJ Health. ©2019 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105. - 7 p. FAQ Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Participating providers and other health care professionals are also under a continuing contractual obligation to correct any previously provided credentialing information that is, or becomes, inaccurate. O. Joan Monaco, DMD, a student of Farleigh Dickenson University Dental School from 1987 – 1990, transferred to and graduated from UMDNJ – NJDS in 1991. Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. The directory will help doctors and their patients find a dental If you qualify for both Medicaid and Medicare, Horizon NJ TotalCare (HMO D-SNP) is the plan that is right for you. It's free! This directory lists Horizon NJ Health participating dentists who treat children under the age of six, organized by county. 10 Horizon NJ Health's Complex Case Management program has a team of nurses and social workers dedicated to helping members with complex medical conditions and who are at risk for admission to the hospital. Products are provided by Horizon Healthcare Dental, Inc. Joan Monaco. All participating Horizon NJ Health practitioners and staff on an annual basis. You can choose which participating PCP you want to see. Review your monthly member panel listing. Horizon Dental negotiates deep discounts with network dentists, so you receive the best value. , each an independent licensee of the Blue Cross and Blue Shield 2. Commercial. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Policy: Digital Member ID Card Policy Effective Date: August 1, 2022 Purpose Require providers to accept Digital Member ID Card as proof of coverage. Find a participating dentist, oral surgeon or other oral health professional here. The risk assessment must be provided at least once per year in conjunction with an oral evaluation service by a PCD. Horizon Code Code Description; A9609: Injection of fluorodeoxyglucose F18 FDG therapeutic, up to 15 millicuries: C9794: Therapeutic radiology simulation-aided field setting; Why choose us as your Paramus, NJ dentist. The program ensures medical and Effective immediately, Horizon NJ Health members no longer need a referral from their Primary Care Provider (PCP) to visit an in-network specialist. Email: providerportal@SKYGENUSA. *Co-pays may apply for some NJ FamilyCare members Dental Home Program for the whole family We now have a program to ensure you and your family have a primary care dentist For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) When you enroll with Horizon NJ Health, you choose a personal doctor or a nurse practitioner called a Primary Care Provider (PCP). gov; USPSTF. Communications may be issued by Horizon Blue Cross Blue Aetna medical and dental plans for the state of New Jersey SHBP and SEHBP members. Welcome to the Horizon NJ Health Dental Program provider network! We are Horizon NJ Health, a program of Horizon Blue Cross Blue Shield of New Jersey. Behavioral health includes both mental health services and Substance Use Disorder treatment services. You can no longer access these plans via NaviNet®. For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Horizon NJ Health’s Pediatric Fluoride Varnish Program encourages pediatricians to apply fluoride varnish to children’s teeth, perform dental assessments, provide anticipatory guidance and Horizon NJ Health Member/Provider Correspondence PO Box 24077 Newark, NJ 07101-0406; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. The purpose of the Dental Policy Manual is to provide Horizon Blue Cross Blue Shield of New Jersey with a tool for the objective comparison of clinical office practices among network You can search for participating doctors or dentists by using our Doctor & Hospital Finder. The Best dentists in Rio Grande, NJ. Call 1-800-682-9090 (TTY Horizon NJ Health shall consider for reimbursement any non-diagnostic outpatient services prior to an admission or same-day surgery performed on the date of an inpatient admission or same-day surgery, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Use the Online Doctor & Hospital Finder to search for dentists who participate with your plan. Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Horizon Dental plans offer: Cost savings when Code Code Description; A9609: Injection of fluorodeoxyglucose F18 FDG therapeutic, up to 15 millicuries: C9794: Therapeutic radiology simulation-aided field setting; complex, including acquisition of positron emission tomography (PET) and computed tomography (CT) scans Imaging data required for radiopharmaceutical-directed radiation therapy treatment Visiting Dental Service of NJ LLC General Dentistry 1999 Cedarbridge Ave Ste 3D Lakewood, NJ 08701 Phone: (201)670-0097 Languages Spoken: English Age Served: 0-99 Hours: MON: 9:00AM - 5:00PM TUE: 9:00AM - 5:00PM WED: 9:00AM - 5:00PM THU: 9:00AM - 5:00PM FRI: 9:00AM - 5:00PM Paula Carvalho , Bright Smile A Visiting Dental Service of NJ LLC Horizon HMO; OMNIA℠ Health Plan; Coverage Outside of New Jersey. Horizon NJ TotalCare (HMO D-SNP) benefits include: Information about Change Healthcare's Security Incident. Horizon Healthcare of New Jersey, Braven Health℠, and/or Horizon Healthcare Dental, Inc. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The app will be free to download. Check what's covered under your plan by signing in at HorizonNJHealth. By proceeding to access this Dental Policies website, you acknowledge receipt of and agreement with the following: The Horizon Blue Cross Blue Shield of New Jersey Dental Programs’ Policy Manual does not constitute dental advice, authorization, certification, approval, explanation of benefits, offer of coverage, contract or guarantee of payment. d/b/a Horizon Blue Cross Blue Shield of New Jersey and/or its affiliates, including Horizon Healthcare of New Jersey, Inc. 2. Effective March 21, 2020, dental consultation by phone call or video chat, also known as teledentistry, is a benefit available to all Horizon NJ Health members. Horizon NJ Health; Horizon PPO; Horizon Tradition; Medicaid A and Medicaid G; MetLife; Straight Medicaid; Horizon Dental Choice, Medicare A&B. Make an appointment online instantly with Oral Surgeons that accept Horizon Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, OMNIA℠ Health Plan; Coverage Outside of New Jersey. The Horizon NJ Health Payer ID is 22326 Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Call Provider Services at 1-800-682-9091, weekdays, from 8 a. 8 million members and one of the largest networks of dental professionals. It's free! We are proud to partner with Horizon Blue Cross Blue Shield of New Jersey, making quality dental care accessible to all and supporting our community’s wellness journey. Horizon NJ Health covers a number of behavioral health benefits. When you stay in-network, you save on out-of-pocket costs and get care from professionals committed to quality standards. , each an On Zocdoc, dentists in Jersey City, NJ have an average rating of 4. Provider Services The Physician and Health Care Hotline at: 1-800-682-9091 . That’s why Horizon NJ Health has a committee made up of doctors and pharmacists who review and approve our formulary. , each an independent licensee of the Blue Cross Blue Shield Under the Dental tab, go to the dropdown menu titled Service you may need. DENTAL POLICY: Dental Provider Termination Involuntary EFFECTIVE DATE: August 15, 2018 LAST REVIEWED DATE: June 12, 2024 LAST REVISED DATE: June 12, 2024 PURPOSE: To outline the process for the termination of a provider and to arrange for continuity of care for a member serviced by the provider in the event that the Provider, Horizon HMO and/or Caries Risk Assessment is provided by the Primary Care Dentist (PCD) and is billed using a current dental terminology (CDT) procedure code. Communications may be issued by Horizon Blue Cross Blue To enroll as a network provider with Horizon NJ Health, as a dental health carepProfessional you will need: To contact SKYGEN USA to request an application for participation with Horizon NJ Health. The policy provision set forth by the State of New Jersey under The NJ Smiles Directory has changed its name to The NJFC Directory of Dentists Treating Children Under the Age of 6. ©2019 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. Claims Addresses Referral Forms, Claims and other billing forms should be submitted to: Horizon NJ Health Claims Processing Department P. Search for doctors, hospitals, urgent care, other health care professionals and more. The reimbursement will be the same regardless of the determined risk level. Call: 1-800-508-6965; Email: networkdevelopment@skygenusa. Health care focused on you Your health benefit options just got even better. Offering a range of services with Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, At Horizon Dental, we’re here to help guide you and your child on the path to a happy and healthy mouth. Horizon HMO; OMNIA℠ Health Plan; Coverage Outside of New Jersey. Facilities: These providers are expected to provide on-site comprehensive dental care (to include intra-oral radiographs Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. Plus, combining dental with medical coverage gives you even more cost-savings and convenience. Check our approved Drug List to see if your medicine is included in your health plan. ” Discover top-notch pediatric dental care in New Jersey with Justbabyteeth Pediatric Dentistry, an in-network provider for Horizon NJ Health and FamilyCare. Box 299, Trenton, NJ 08625-0299 Videos More videos are available to view in our Video Library DENTAL POLICY: Dental Continuity of Care Policy EFFECTIVE DATE: December 1, 2011 LAST REVIEWED DATE: June 12, 2024 LAST REVISED DATE: June 12, 2024 PURPOSE: The policy is to ensure our members are provided continuity of care when transferred from a different MCO to HNJH. Certain services require authorizations and are Horizon NJ Health does not accept outpatient consultation services, CPT codes 99242-99245. The policy provision set forth by the State of New Jersey under Horizon Dental has extensive local and national networks of skilled, credentialed dentists and specialists. considered for members with special health care needs. Now and Always. This material is presented to ensure that Physicians and Health Care Professionals have the information required to provide benefits and services for Horizon NJ Health members. Important - Please Read. BACK back to www. When Please refer to Availity Essentials™ is the provider portal for Horizon NJ Health, Horizon Blue Cross Blue Shield of New Jersey and Braven Health. Horizon Health Center provides free dental care to low-income residents of Jersey City, NJ. Horizon NJ TotalCare (HMO D-SNP) offers: $0 copays $0 premiums No referrals A $0 gym membership or home fitness program $375 per quarter on an Over-the-Counter (OTC) Benefit Card to spend on health items at participating retail stores When you enroll with Horizon NJ Health, you choose a personal doctor or a nurse practitioner called a Primary Care Provider (PCP). S health care system, is experiencing a cyber security issue that is affecting the business operations of many companies nationwide, including Horizon. Communications Individual practitioners and group practices seeking to join our Horizon NJ Health network must complete this form in compliance with state and federal guidelines. Horizon Healthcare of Horizon Health Center provides free dental care to low-income residents of Jersey City, NJ. com or by calling 1-800-682-9090 (TTY 711). He serves as consultant on numerous The Horizon Behavioral Health℠ program supports our members in getting access to safe and effective mental health and Substance Use Disorder care. Members may call them at 1-866-527-9933 (TTY 1-866-288-3133) to set up a transportation appointment. Always confirm enrollment before providing services. Columbia Dental is a full-service dental clinic with offices in Hamilton and Elizabeth, New Jersey, specializing in cosmetic dentistry. However, Horizon NJ Health recognizes that members in long term care (LTC) facilities may be on medications that cause an increase Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) ADMINISTRATIVE POLICY NJ Health Appointment Availability Access Standards for Primary Care-Type Providers, Ob/Gyns, Specialists and Behavioral Health Providers EFFECTIVE DATE March 22, 2000 LAST REVIEWED DATE February 20, 2024 PURPOSE To ensure appointments for medical, mental health/substance use disorder (for DDD clients, Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. However, Horizon NJ Health recognizes that members in long term care (LTC) facilities may be on medications that cause an increase Horizon NJ Health's Complex Case Management program has a team of nurses and social workers dedicated to helping members with complex medical conditions and who are at risk for admission to the hospital. It’s important that the medicine you take is safe and effective. The program ensures medical and behavioral health services are available to help members better manage their overall health. View authorizations, covered benefits and fee schedules online, anytime on the SKYGEN USA Provider Portal. Make an appointment online instantly with Oral Surgeons that accept Horizon Blue Cross Blue Shield of New Jersey insurance. Growing up, I have always had an interest in health care, especially in dentistry. In Jersey City, NJ you can find 97 dentists with 4-stars or higher. Restorative Dentistry: Offering tooth-colored fillings, crowns, and pulp therapy, designed specifically for young, developing teeth. Braven Health, and/or Horizon Healthcare Dental, Inc. Communications may If you are eligible for both Medicaid and Medicare, you can get all your health care benefits at no cost under one, convenient plan. Communications may be issued by Horizon Blue Cross Blue Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Members should receive oral evaluation and preventive services by a dentist twice a year. Later this year, you will be able to use the Horizon NJ Health App to quickly and easily access your benefits from your smartphone or tablet. com/doctorfinder and sign in or continue as a guest. If you have questions or concerns about the information presented, please write to the Health Benefits Bureau, Division of Pensions & Benefits, P. Their exceptional dentists deliver high-end care and family treatments all in one conveniently located practice. to 5 p. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Horizon NJ Health Care / Case Manager To speak with a Horizon NJ Health Horizon Health Center is a medical group practice located in Jersey City, NJ that specializes in Dentistry and Midwifery, and is open 5 days per week. We empower our members to achieve their best health by leading with strength, integrity and innovation to generate substantial improvements in health care quality, affordability and member experience. With one easy plan, from a name you trust, you get a team of doctors, specialists and Care Managers working together just for you. Communications may be issued by Horizon Blue Cross Blue Count on Aspen Dental's skilled team for all your oral health needs, from dental checkups to advanced procedures like dentures and implants. For your care to be covered . Box 24078 Newark, NJ 07101-0406 Appeals Addresses Utilization Management Decisions Appeals should be submitted to: Skip to main content Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. , each an independent licensee of the Blue Cross Blue Shield Horizon Health Center, a Medical Group Practice located in Jersey City, NJ. Communications may be issued by Horizon Blue Cross Blue to access high-quality, affordable dental care with all the flexibility you need. Dental Plan Webinars for 11/16/24-12/15/24 Retiree Special Open Enrollment Period; Horizon Dental Expense Plan (Actives) State Health Benefits Plan Retirees (DEP) School Employees' Health Benefit Plan Retirees (DEP) Horizon NJ Health created GEMS to ensure that expecting members get proper prenatal care and education on how to have a healthy pregnancy and baby. Dr. Horizon NJ Health covers thousands of medicines. Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. The average charge for treatment is 20% to 40% less than other carriers, stretching your dollars. Away From Home Care Program; Traveling Abroad; Dental Plans. Horizon NJ Health hosts Community Health Advisory Committee meetings with members, community health advocates and community leaders to talk about ways to improve member services, health education and outreach activities. d/b/a Horizon NJ Health (collectively ADMINISTRATIVE POLICY NJ Health Appointment Availability Access Standards for Primary Care-Type Providers, Ob/Gyns, Specialists and Behavioral Health Providers EFFECTIVE DATE March 22, 2000 LAST REVIEWED DATE February 20, 2024 PURPOSE To ensure appointments for medical, mental health/substance use disorder (for DDD clients, Horizon NJ Health ensures that members with special needs get care and services equal in quality and accessibility to services provided to all Horizon NJ Health members. Horizon Healthcare of New Jersey, Braven Health, and/or The physician and dentist remains responsible for the quality and type of health care services provided to a Horizon NJ Health member. Communications may be issued by Horizon Blue Cross Blue Participating Plan(s): Horizon NJ Health Richman Dental Associates 5-21 Saddle River Road Fair Lawn, NJ 07410 Sees Children Over Age 6 Participating Plan(s): Horizon NJ Health Sparkle Kids Dentistry 15 01 Broadway Fair Lawn, NJ 07410 Sees Children Age 6 and Under Participating Plan(s): Horizon NJ Health, United Healthcare Community Plan Horizon NJ Health failed to provide services, including access, according to their State MCO contract. - 5 p. Learn about our dental plans. Communications may be issued by Horizon Blue Cross Blue Horizon NJ Health covers many vaccines at no cost to members. To enroll as a network provider with Horizon NJ Health, as a dental health carepProfessional you will need: To contact SKYGEN USA to request an application for participation with Horizon NJ Health. Call (201) 451-6300 to schedule an appointment. Find Providers by Specialty Find Providers by Procedure. , each an independent licensee of the Blue Cross Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. ABA Services Provider Directory for Horizon NJ Health members Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Communications may be issued by Horizon Blue Cross Blue For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. It's free! All appointment times are guaranteed by our Horizon NJ Health Dentists & Providers. com Providers who have registered for the portal can: The complete list of Horizon NJ Health specialists is available in the Doctor & Hospital Finder. With our Horizon Dental Expense Plan (DEP), you get: • The freedom to choose from more than 18,000 provider locations in New Jersey and more than 480,000 nationally For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. specialty These services major include restorative preventative, dental services. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon The Horizon BCBSNJ Dental Program offers your employees a dedicated staff, focused on helping members take control of their oral health. , Eastern Time. rt of Horizon NJ Health?a pa Answer: No. Teledentristy is a way for you to speak with your dentist about your dental emergency during the COVID-19 pandemic. GEMS stands for “Getting Early Maternity Services. If you would like a printed copy of the Provider Directory, please call Member Services toll free at1-800-682-9090 (TTY 711), 24 hours a day, seven days a week. Revised Forms. surgical center is covered with prior authorization Horizon NJ Health members receive a comprehensive dental benefit that includes oral exams, preventive services and treatment. You can also make your reservation online at mymodivcare. Dental Plan Webinars for 11/16/24-12/15/24 Retiree Special SKYGEN USA administers dental services for Horizon NJ Health members. Dental Plan Webinars for 11/16/24-12/15/24 Retiree Special Open Enrollment Period; Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. If you require hard copies of any of this information please call the Physician and Health Care Hotline at 1-800 This policy applies to the Medicaid/NJ FamilyCare and Fully Integrated Dual Eligible Special Needs (“FIDE-SNP”) plans issued and/or administered by Horizon Healthcare Services, Inc. Loaning or selling your Horizon NJ Health member ID card or information on the card to someone else; Forging or changing prescriptions; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Meet Our Dental Directors . Columbia Dental is dedicated to putting the needs of its patients first. This nationwide plan is great for members who like the freedom to go in and out of network. Horizon NJ Health has policies and procedures for prior authorization and mechanisms to ensure consistent application of service criteria for authorization decisions. A physical member ID card is not a guarantee of member eligibility. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity Find Horizon Blue Cross Blue Shield of New Jersey Oral Surgeons & Providers with verified reviews. Toggle menu. ” Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. Horizon NJ Health’s Policies do not constitute medical or dental advice, authorization, certification, approval, explanation of benefits, offer of coverage, contract or guarantee of payment. Dental treatment in an operating room or ambulatory . com Call by noon at least 2 days before you need the ride. It covers all Medicare and Medicaid benefits, plus additional features and services all at no cost to you. Who are Horizon NJ Health's members with special needs? Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. , each an Horizon NJ Health's MLTSS program helps members who need support services to remain in their homes and communities as long as possible. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. For dental providers both in and out of NJ, choose Find Care in NJ. horizonblue. com Providers who have registered for the portal can: For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Yes, all Horizon NJ Health members have dental coverage, which is shown on your Horizon NJ Health member ID card. Compliance with Horizon NJ Health’s recredentialing standards is an ongoing contractual responsibility of all participating providers and other health care professionals. Find a Horizon NJ TotalCare (HMO D-SNP) doctor or hospital. Services include preventive care, restorative care, extractions, and emergency dental Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Find Horizon Blue Cross Blue Shield of New Jersey Oral Surgeons & Providers with verified reviews. Horizon Dental is New Jersey’s largest insurer with 1. , each an independent licensee of the Blue Cross Blue Shield Association Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc. eviCore helps to ensure our members receive appropriate radiology/imaging services, provides clinical consultation to our participating healthcare For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Horizon Dental Choice New Jersey State Health gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. , each an independent licensee of the Blue Cross Blue Shield Compliance with Horizon NJ Health’s recredentialing standards is an ongoing contractual responsibility of all participating providers and other health care professionals. Dental Plan Webinars for 11/16/24-12/15/24 Retiree Special Open Enrollment Period; Horizon Dental Expense Plan (Actives) State Health Benefits Plan Retirees (DEP) School Employees' Health Benefit Plan Retirees (DEP) For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) The Dental Expense Plan is exclusively offered to active SHBP & SEHBP members. Some services are covered by Horizon NJ Health, while others are paid for directly by Medicaid Fee-for-Service (FFS). Insurance Providers Overview Location Reviews Insurance Check For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Horizon NJ Health Electronic Data Interchange (EDI) Electronic Funds Transfer (EFT) Electronic Remittance Advice (835) Enrollment Form; Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. For any services where our existing fee schedule is For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc. You have the option of selecting from more than 381,000 office locations nationwide. , each an independent licensee of the Blue Cross Horizon NJ Health selected Availity Essentials to improve your user experience and make it easier for you to provide quality care to your patients. Additionally, when you use a dentist who participates in the Horizon Dental PPO Network, you receive deeper discounts and may save even more. Monaco's Bio. If Find Horizon NJ Health Dentists & Providers with verified reviews. 1 Contents Introduction. Communications may be issued by Horizon Blue Cross Blue Modivcare is the transportation vendor for people enrolled in Medicaid or NJ FamilyCare. Did you Participating Plan(s): Horizon NJ Health Richman Dental Associates 5-21 Saddle River Road Fair Lawn, NJ 07410 Sees Children Over Age 6 Participating Plan(s): Horizon NJ Health Sparkle Horizon Health Center is a medical group practice located in Jersey City, NJ that specializes in Dentistry and Midwifery, and is open 5 days per week. You will find details in the chart below. Communications may be issued by Horizon Blue Cross Blue Horizon NJ Health is updating our fee schedule for behavioral health services to more closely align with the Behavioral Health Rate Increase announced in the Division of Medical Assistance & Health Services’ (DMAHS) Medicaid Alert, dated August 2023 and the rate and code information accessible through NJMMIS. Call 201-478-5800 today to schedule your 2. It may be provided a second time with As a Horizon NJ Health member, you get the benefits and services you are entitled . Select the appropriate dental benefit (such as Dental Crowns or Orthodontics), then Show Coverage Details. Caries Risk Assessment is provided by the Primary Care Dentist (PCD) and is billed using a current dental terminology (CDT) procedure code. One of our top priorities is to ensure our members have access to the health care they need. When you use a dentist who participates with the Horizon Dental Option Plan, you maximize your benefits and save money. , each an independent licensee of the Blue Cross Blue Shield Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. Additional materials are available for participating providers via Availity Essentials™. Find Providers by Condition Horizon BCBS Dental PPO; Horizon BCBS Direct Access; Horizon BCBS HMO; Horizon BCBS OMNIA; Horizon BCBS OMNIA - TIER1; Horizon NJ Health introduced its new mascot "NJ" who helps teach children good health, nutrition and dental care. NJ FamilyCare Dental Services Clinical Criteria Policy (effective January 1, 2024) NJ FamilyCare Dental Services Clinical Criteria Policy (effective January 1, 2024) Noncompliant members For Enrollment: 1-800-637-2997 Hearing or speech impaired: TTY 711; For Member Services: 1-800-682-9090 (TTY 711) Horizon HMO; OMNIA℠ Health Plan; Coverage Outside of New Jersey. Find Horizon NJ Health Dentists & Providers with verified reviews. Dental care is available only at our 935 Garfield Avenue facility Monday and Thursday from 9 a. The Horizon Behavioral Health℠ program supports our members in getting access to safe and effective mental health and Substance Use Disorder care. It has allowed me to exercise my Horizon NJ Health- Dental . ; Tuesday, Wednesday and Friday from 9 a. With Horizon, you have the choice to get the care you need from some of the largest networks of health care professionals across New Jersey and beyond. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of Horizon NJ Health partners with eviCore healthcare (eviCore) to manage Advanced Imaging Services for our members through Prior Authorizations/Medical Necessity Determinations (PA/MND) with providers. m. Your level is based on your health, income and the number for Skip to main content. Instead of billing for consultation codes, providers must use the appropriate evaluation and management code from range 99202-99215, in accordance with the chart below, depending on the complexity of the visit and whether the patient is a new or . To submit claims and receive reimbursements for Horizon NJ Health members, we encourage providers, vendors and clearinghouses to establish EDI capabilities with us. Change Healthcare, a vendor that connects payers, providers and patients within the U. Always consult your physician for individual care. , each an Products are provided by Horizon Health Care Dental and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross Blue Shield Association. Sources: CDC. If you receive Managed Long Term Services & Supports (MLTSS) benefits, please view the MLTSS benefit chart. Your Primary Care Provider (PCP) coordinates all of your heath care needs. , each an independent licensee of Claims Addresses Paper Claim Submissions: Horizon NJ Health Claims Processing Department PO Box 24078 Newark, NJ 07101-0406 Member/Provider Correspondence: Horizon NJ Health Member/Provider Correspondence PO Box 24077 Newark, NJ 07101-0406 Appeals Addresses Horizon NJ Health hosts Community Health Advisory Committee meetings with members, community health advocates and community leaders to talk about ways to improve member services, health education and outreach activities. 82 based on approximately 1008 reviews. xqd nugcr yofaxg uanev vtcyg hgkuj opxg cie cpoj wmxv