Shbp Horizon (2024)

FAQs

Does Quest Diagnostics accept Horizon NJ Health? ›

Testing and expertise

Quest Diagnostics is an independent company that supports Horizon Blue Cross Blue Shield of New Jersey.

For claims that are submitted by mail, there is a 30-day processing period. Generally, for claims submitted through your account on our website or the Horizon Blue app, you can check the status of the claim in 10 business days, but it may take up to 30 days to be finalized.

Headquartered in Hopewell, NJ, Horizon NJ Health is wholly owned by Horizon Blue Cross Blue Shield of New Jersey. Achieving the goals established in the mission, vision and cornerstone statements are at the heart of everything that is done at Horizon NJ Health.

Corrected Claims

Both paper and electronic claims must be submitted within 365 calendar days from the initial date of service.

Labcorp is the exclusive laboratory services provider for Horizon NJ Health.

Except for full-time students, Horizon shall not be responsible for out of state coverage for care of a Medicaid member residing outside of NJ for more than 30 days.

Horizon NJ Health is the leading Medicaid and NJ Family Care plan in the state and the only plan backed by Horizon BCBSNJ.

Claim Status. A health care claim status inquiry and response transaction is a communication between a provider and a payer about a health care claim. A claim status transaction is used for: • An inquiry from a provider to a health plan about the status of a health.

As a member of Horizon NJ Health, you get the benefits and services you are entitled to with the NJ FamilyCare Program. The medical care and services you get through Horizon NJ Health are free or low cost.

MoneyGeek's top pick for the best health insurance in New Jersey is Aetna CVS Health. This provider offers four Silver EPO plans. Its average plan rate is $424 per month, and the average MOOP cost for these plans is $8,850. Aetna CVS Health provides Silver EPO plans.

What is the income limit for get covered in NJ? ›

New Jersey Health Plan Savings

In 2024, an individual with an income of up to $87,480 and a family of four who makes up to $180,000 can receive state subsidies to lower the costs of health coverage.

How much does health insurance cost in New Jersey? The average cost of health insurance in New Jersey is $550 per month for a 40-year-old with a Silver plan. The level of coverage you buy has one of the biggest effects on your rate. Plans that give you more coverage, like Gold, cost more each month.

All appeals must be submitted within 60 days of the date of the denial letter. Please follow the appeal process described below. You also have the right to ask the State to review Horizon NJ Health's decision about your service.

CORRECTED CLAIMS AND INQUIRIES

ITS and Fund Accounts must submit corrected claims using Form 579, Inquiry Request and Adjustment Form. For corrected claims processed by eviCore healthcare for radiology services, use Form 579 to add multiple bill lines not included in the original claim submission.

You can submit out-of-network medical and behavioral claims using the Horizon Blue App or by mail. Horizon Blue App: To submit these claims using the Horizon Blue App, sign in to the Horizon Blue App and tap Claims, then Submit a Claim.

Horizon NJ Health, New Jersey's largest managed healthcare company serving the publicly insured, provides quality healthcare services for more than 500,000 children and adults in the Medicaid and NJ FamilyCare programs. Horizon NJ Health provides benefits for New Jersey residents enrolled in the Medicaid program.

You can fill your prescription(s) at one of more than 2,000 convenient pharmacy locations throughout New Jersey, including major retail pharmacies such as CVS, Walgreens and Rite Aid.

Horizon NJ Health is the leading Medicaid and NJ Family Care plan in the state and the only plan backed by Horizon BCBSNJ. Our members get the health benefits they can count on from a name they trust.

Horizon NJ Health is the largest Medicaid and NJ FamilyCare plan in New Jersey and the only plan backed by Horizon Blue Cross Blue Shield of New Jersey.