Skip to main content

Horizon Behavioral Health: Change in Management of the Horizon Behavioral Health Program Frequently Asked Questions

May 30, 2019

Horizon Blue Cross Blue Shield of New Jersey will transition the administrative and clinical management of the Horizon Behavioral Health℠ program – behavioral health services and benefits – from Beacon Health Options (formerly ValueOptions) to Horizon BCBSNJ’s internal operations.

The transition to Horizon BCBSNJ’s internal management will occur in a phased approach based on line of business. The effective dates are targeted for on or about:

  • January 1, 2020: Horizon Medicare Advantage, Horizon NJ Health and Horizon NJ TotalCare (HMO SNP) plans
  • April 1, 2020: Horizon BCBSNJ fully insured plans/products, self-insured (Administrative Services Only [ASO]) employer group plans including the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP) and the Federal Employee Program® (FEP®)

We will continue to provide updates as Horizon BCBSNJ works with Beacon Health Options to prepare for the full transition of the Horizon Behavioral Health program.

Below are answers to questions you may have about the change in the management of the Horizon Behavioral Health program from Beacon Health Options to Horizon BCBSNJ’s internal operations.

Q1. Why are we making this change?

A1. Internal management of behavioral health services and benefits will allow us to be in a stronger position to work directly with providers and health systems to improve the integration of physical health and behavioral health care for our members and to assist health care professionals in treating the whole member and their unique needs.

Q2. Which plans/products will be impacted on or about January 1, 2020?

A2. The following plans/products will transition to Horizon BCBSNJ internal operations on or about January 1, 2020:

  • Horizon Medicare Advantage plans
  • Horizon NJ Health plans including:
    • Medicaid Managed (Division of Developmental Disabilities [DDD]),
    • NJ FamilyCare
    • Managed Long Term Services & Supports (MLTSS) plans
  • Horizon NJ TotalCare (HMO SNP)

Q3. Which plan/products will be impacted on or about April 1, 2020?

A3. The following plans/products that include behavioral health benefits through the Horizon Behavioral Health program will transition to Horizon BCBSNJ internal operations on or about April 1, 2020:

  • Horizon BCBSNJ fully insured plans/products and self-insured (Administrative Services Only [ASO]) employer group plans, including:
    • Advantage EPO
    • Direct Access
    • EPO
    • HMO
    • Indemnity
    • OMNIA℠ Health Plans
    • PPO
    • POS
    • State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP)
  • Federal Employee Program® (FEP®)

Q4. Are all plans/products impacted?

A4. All plans that include behavioral health benefits through the Horizon Behavioral Health program will be impacted by this change in the administrative and clinical management of the Horizon Behavioral Health program.

Q5. How will this change in the administrative management of the Horizon Behavioral Health program help providers to improve behavioral services offered to our members?

A5. Internal management of behavioral health services and benefits will allow us to be in a stronger position to work directly with providers and health systems to improve the integration of physical health and behavioral health care for our members and to assist health care professionals in treating the whole member and their unique needs.

Q6. Will current Horizon Behavioral Health Provider Agreements be impacted by the change in the management of behavioral health benefits?

A6. Existing Horizon Behavioral Health practitioner and facility agreements will NOT be impacted by the change in the management of behavioral health benefits.

Q7. Will the Horizon BCBSNJ provider networks change?

A7. The transition from Beacon Health Options to Horizon BCBSNJ’s internal operations will have no impact on the participation status of any doctors, other health care professionals, ancillary providers or facilities that treat patients as part of the Horizon Behavioral Health program.

Q8. Why is Horizon BCBSNJ announcing this change now?

A8. Horizon BCBSNJ is announcing this change to ensure our providers are aware of the transition and to let them know we will communicate any details regarding this change during the transition.

Q9. Will there be changes to the recredentialing process?

A9. Yes. Effective July 1, 2019, Horizon BCBSNJ will begin to manage the recredentialing of behavioral health practitioners and facilities for providers who are due to be recredentialed on and after January 1, 2020. Beacon Health Options will continue to manage the recredentialing process for practitioners and facilities that are due to be recredentialed through December 31, 2019

Practitioners and facilities due for recredentialing on or after January 1, 2020 will receive information directly from Horizon BCBSNJ regarding recredentialing next steps.

Q10. Who is Medversant and what do they do for Horizon BCBSNJ?

A10. Medversant is a credentialing verification organization that works with Horizon BCBSNJ to collect recredentialing documentation for participating Horizon BCBSNJ and Horizon NJ Health doctors and other health care professionals.

Horizon BCBSNJ will handle all credentialing and recredentialing for ancillary and acute care facilities.

Q11. Does Medversant handle recredentialing for all of Horizon BCBSNJ’s networks?

A11. Yes, Medversant provides assistance in regard to the recredentialing of participating doctors and other health care professionals for all of Horizon BCBSNJ’s networks.

Q12. Should I contact Medversant about my recredentialing?

A12. There is no need for you to contact Medversant or send them any documentation at this time. Horizon BCBSNJ will provide additional information about the recredentialing process for behavioral health practitioners and facilities as the effective date for this change approaches.

Q13. Where can behavioral health professionals access new information regarding the transition?

A13. Information and updates about the Horizon Behavioral Health program transition will be posted on HorizonBlue.com/providernews and horizonNJhealth.com/providernews. We encourage you to check these web pages regularly for updates.

Q14. Who will my Network Specialist be following this transition?

A14. Horizon BCBSNJ will provide full details and instructions about Horizon Behavioral Health program contacts as we get closer to the transition dates. Please continue to work with your current Beacon Health Options contacts.

 

 

Medversant supports Horizon Blue Cross Blue Shield of New Jersey in the administration of credentialing and recredentialing services. Medversant is independent from and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. The Horizon Behavioral HealthSM.program is administered by ValueOptions of New Jersey, Inc. ValueOptions of New Jersey, Inc., a subsidiary of Beacon Health Options, Inc., is a New Jersey Corporation licensed by the NJ Department of Banking & Insurance as an Organized Delivery System.