Changes to the Management of the Horizon Behavioral Health Program
New Information Posted: Changes to the Management of the Horizon Behavioral HealthSM Program
New information related to the transition of the management of the Horizon Behavioral HealthSM Program, including:
- Credentialing new behavioral health professionals and ancillary facilities on and after October 1, 2019.
- Initiating/requesting updates to provider demographic information on and after October 1, 2019.
- The medical necessity criteria that will be used to make utilization management determinations for behavioral health services beginning January 1, 2020.
Newly Credentialed?
Quick Reference Guide for Horizon Behavioral health Providers (QRG)
Important Documentation
- Quick Reference Guide for Horizon Behavioral Health Providers
- Horizon Blue Cross Blue Shield of New Jersey Code of Conduct
- Member Rights and Responsibilities
- Quality Management/Utilization Management Program Description
- Provider Treatment Record Review – Q&A for Horizon Behavioral Health
- Behavioral Health Fee Changes Frequently Asked Questions
Forms and Other Links
- ABA Request Form 2019
- ABA NJ Medical Necessity Criteria
- ABA Report Guidelines
- The New Jersey Substance Use Disorder: Provider Resources
- Discharge Review Form
- Horizon Psychological and Neuropsychological Assessment Supplemental Form
- Horizon Blue Cross Blue Shield New Jersey Website
Contact Information
- Provider Relations, and Contracting Questions:
- horizonbehavioralhealthproviderrelations@beaconhealthoptions.com
- (800) 397-1630 (8 a.m.–8 p.m. ET, Monday–Friday)
- For Provider File Updates, Credentialing and Recredentialing: HorizonBlue.com/providershbh
- Authorizations, Care Management, Complaints/Appeals, Claims, and/or General Inquiries:
- (800) 626-2212 or (800) 991-5579 (for NJ State Health Benefits Program)
- EDI Help Desk
- (888) 247-9311 (8 a.m.–6 p.m. ET, Monday–Friday)
- NaviNet
- (888) 482-8057 or Navinet.net