Contact Us - Horizon NJ Health (2024)

Provider Contacts

General Contacts‌General Contacts

Provider Services 1-800-682-9091
Behavioral Health: For children younger than 18 years of age Children requiring Care Management assistance for behavioral problems or mental health issues should be directed to the State of New Jersey's Children's System of Care Program at 1-877-652-7624. Staff is available 24 hours a day, seven days a week. DDD, MLTSS and FIDE-SNP members can call our Member Services for assistance.
Behavioral Health: For adults 18 years and older The NJ Mental Health Cares Program, New Jersey's mental health information and referral service, is available during normal business hours at 1-866-202-4357. Hotline staff will refer members to community mental health programs throughout the State of New Jersey. DDD, MLTSS and FIDE-SNP members can call our Member Services for assistance.

Members not enrolled with DDD, MLTSS or FIDE-SNP should call their local Medical Assistance Customer Center (MACC) for mental health services. To find the number of a local MACC, call the NJ FamilyCare hotline toll free at 1-800-701-0710 (TTY 711).

Behavioral Health: After Hours Member may call the State of New Jersey's 211 program toll free at 1-877-652-1148 (TTY 711), 24 hours a day, seven days a week.
1-800-682-9094 x89385
Type of Calls
  • Member inquiries/referrals
  • Maternity Program (Mom's GEMS)
Division of Developmental Disabilities (DDD): 1-800-682-9094 x89906
Division of Child Protection and Permanency (DCPP): 1-800-682-9094 x89907
Care/Case and Disease Management: 1-800-682-9094 x89634
Type of Member
  • Any member is eligible for Care Management.
Consent for Sterilization A Family Planning Prior Authorization Request form and a HHS-687 Consent for Sterilization Form must be completed and signed by the member in advance of a sterilization procedures being performed. We require that all Consent for Sterilization Forms be submitted to its Health Services Department by faxing the form to 1-609-583-3047 at least 30 days in advance of the procedure.
Davis Vision 1-800-933-9371
Discharge Planning 1-800-682-9094 x89347; Fax: 1-609-583-3029
eviCore 1-866-496-6200
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)
Horizon NJ Health Enrollment Hotline
For information on enrollment
LabCorp 1-800-631-5250
ModivCare (Transportation) 1-866-527-9933 (TTY 1-866-288-3133)
Managed Long Term Services & Supports (MLTSS) Member Services 1-844-444-4410 (TTY 711)
MLTSS Claim Inquiries Email:
MLTSS Provider Services 1-855-777-0123
Member Services
Someone is available 24 hours a day, seven days a week to help you
1-800-682-9090 (TTY 711)
NaviNet Customer Care 1-888-482-8057
New Jersey State Health Benefits Coordinator (HBC)
For questions about the status of your application
1-800-701-0710 (TTY 1-800-701-0720)
Pharmacy Department 1-800-682-9094
SKYGEN USA Dental Provider Services 1-855-878-5368

Network Relations Assignments‌Network Relations Assignments


Claims and Appeals‌Claims and Appeals

Claims Claims and other billing forms should be submitted to:
  • Horizon NJ Health
    Claims Processing Department
    P.O. Box 24078
    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
Utilization Management Appeals Utilization Management decisions appeals should be submitted to:
  • Horizon Medical Appeals
    PO Box 10194
    Newark, NJ 07101

Or Fax to 1-609-583-3028

You can also request an appeal by calling the UM Appeals Department at
1-800-682-9094, ext. 9606, prompt 2.

Administrative Claim Appeals Administrative Claim Appeals should be submitted to:
  • Horizon NJ Health
    Administrative Claim Appeals
    PO Box 63000
    Newark, NJ 07101

Or Fax to 1-973-522-4678

For questions regarding billing or appeals, please contact the Physician and Health Care Hotline at 1-800-682-9091 and/or your Professional Relations Representative.

Changes to Your Practice‌Changes to Your Practice

We are required to maintain accurate information in our provider database. This information is essential for providing access to services for our members.

It is your responsibility to notify us prior to any change in the status of the practice or provider. This includes the sale or purchase of a practice, the addition of a provider or the retirement of a provider. In the case of a provider death, the practice should notify Horizon NJ Health immediately.

How to update your demographic information.

If you are terminating from the network, you must send a notice via certified mail, as per your agreement. Please send notification via certified mail with return receipt to:

Horizon NJ Health
1700 American Blvd
Pennington, NJ 08534
Attention: Network Relations

If you have any questions about this requirement, please contact your Network Specialist or Ancillary Contract Specialist.


Service Contact Authorization Type
Inpatient 1-800-682-9094 x81024
  • Notification of Admission
  • Scheduled Inpatient Requests
  • Observations
  • Authorizations for MLTSS members are coordinated through our UM Department with the exception of NF Custodial Care and NF Respite Care. If the request is for NF Custodial or NF Respite, Providers need to call 1-844-444-4410 to obtain authorizations.
Outpatient Facility Office Based 1-800-682-9094 x81023
  • Chiropractic
  • Dialysis
  • Genetic Testing
  • Infusion - Facility
  • Injectables
  • Non par Physician
  • Office Visit Visits
  • Procedure
  • Pain Management
  • Sleep Study
  • Same Day Surgery (SPU)
  • Therapies: Chemo, Radiation, Pulmonary, Cardiac, Nutrition
  • Standing Referrals
  • Transplant
  • Wound Care - Facility
Home Services 1-800-682-9094 x81025
  • Skilled Nursing
  • Home Infusion
  • Home Hospice
  • Home - Lab Corp
  • Home - PT/OT/ST Draws
Medical Day Care 1-800-682-9094 x81364
Fax: 1-609-583-3048
  • Adult
  • Pediatric
Personal Care Assistance 1-800-682-9094 x81364
Fax: 1-609-583-3048
Durable Medical Equipment & Medical Supplies 1-800-682-9094 x81017
  • DME/Medical Supplies
  • Orthotics
  • Prosthetics
Facility PT/OT/ST 1-800-682-9094 x81623
Personal Preference Program (PPP) 1-855-465-4777

Community Resources‌Community Resources

Resource Service and Contact
2-1-1 Educate members on the benefits of dialing 2-1-1 on a telephone, 24 hours a day, seven days a week, to be connected to social service programs and crisis intervention hotlines.
Adult Protective Services (APS) 1-800-792-8820, or NJ EASE 1-877-222-3737
New Jersey Division of Developmental Disabilities (DDD) 1-800-832-9173
DDD determines those who are eligible to receive services it funds through its application process. Generally, to receive services, you must show that you have a severe, chronic physical and/or mental impairment that:
  • Manifests in the developmental years, before age 22
  • Is life-long
  • Substantially limits you in at least three of the following life activities: self-care, learning, mobility, communication, self-direction, economic self sufficiency and the ability to live independently
Division of Child Protection and Permanency (formerly DYFS) To report child abuse or neglect: 1-877-NJ ABUSE (652-2873)
NJ Addiction Services HotlineThere is help available for those who need assistance with a drug or alcohol problem. For assistance and a referral for treatment, the NJ Addiction Services Hotline can be reached toll-free at 1-844-276-2777. Help is available 24 hours a day, seven days a week.
Contact Us  -  Horizon NJ Health (2024)
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