Horizon NJ Health

Horizon NJ Health Quick Reference Guide approved August 26, 2026. Claims questions, COB, behavioral health claims and enrollment questions. Medicaid members only; Horizon BCBSNJ commercial uses 1-800-624-1110.

General provider services number for the fully integrated dual eligible special needs plan.

Managed Long Term Services and Supports (MLTSS) provider services and MLTSS behavioral health authorizations.

Submit elective requests via the UM Request Tool on Availity Essentials or by phone at least 14 calendar days before service; also for status checks. SUD requests go through NJSAMS. Medicaid behavioral health PA uses the same number.

Behavioral health (mental health, autism, substance use) for TotalCare D-SNP. DDD behavioral health PA: 1-877-695-5612.

Horizon NJ Health pharmacy department, extension 81016. TotalCare D-SNP pharmacy services: 1-855-457-1347.

Electronic Payer ID 22326. No handwritten or black-and-white claims. Timely filing 180 days from DOS/discharge; corrected claims within 365 days. COB claims need the primary EOB.

Send the claim appeal application form (horizonNJhealth.com/for-providers) with supporting documentation by mail or fax.

EDI setup and technical support; Payer ID 22326. Change Healthcare 1-877-461-9605 handles 835/EFT for nursing facilities.

SKYGEN USA administers Horizon NJ Health dental: eligibility, claims, authorizations, credentialing. Dental claims payer ID 22099; paper ADA claims to the address below; paper authorizations to PO Box 362, Milwaukee, WI 53201.

Enroll via the online Enrollment Tool or mail a Credentialing Checklist Application. Dental credentialing is through SKYGEN (phone 1-855-812-9211, fax 1-866-396-5686).

Service delivery for members with special needs or disabilities.