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Credentialing Update: Ensure You Use the Current Agreement

Doctors and other health care professionals (including behavioral health practitioners) who are seeking to join the Horizon Managed Care Network and Horizon PPO Network, or the Horizon NJ Health Networks must include completed and signed Agreements with their initial credentialing applications.

To ensure that your initial credentialing application is processed, make sure you use the current Agreement.

The footers of our current Agreements include the version numbers noted in the table below.

Agreement Version #
Horizon Healthcare of New Jersey, Inc. Agreement with Participating Physicians and
Other Healthcare Professionals (Agreement)

This Agreement is for participation in the Horizon Managed Care Network. The Agreement allows you to treat members enrolled in Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) managed care plans (e.g., OMNIASM Health Plans, Horizon HMO, Horizon Direct Access, Horizon Medicare Advantage) at an in-network level of benefits.
W0117
Horizon Blue Cross Blue Shield of New Jersey Agreement with Participating Physicians and Healthcare Professionals (Agreement)
This Agreement is for participation in the Horizon PPO Network. The Agreement allows you to treat members enrolled in Horizon BCBSNJ’s PPO and Indemnity Plans at an in-network level of benefits.
W0117
Horizon NJ Health Government Programs Provider Agreements (Agreements)
There are four Agreements for participation in the Horizon NJ Health Networks based on practitioner type/specialty. These Agreements are for participation with plans that allow you to treat members enrolled in Horizon NJ Health Medicaid, NJ FamilyCare, Managed Long Term Services & Supports (MLTSS) and Horizon NJ TotalCare (HMO D-SNP) plans.
  1. For Physicians and most Other Healthcare Professionals
  2. For Behavioral Health Practitioners
    • This Agreement is for participation in the Horizon NJ Health Behavioral Health Network, which allows you to treat members enrolled in Horizon NJ Health DDD, MLTSS and FIDE-SNP plans.
  3. For Nurse Practitioners and Physician Assistants
  4. For Occupational Therapists, Physical Therapists and Speech Therapists
V.2020.01

Accessing our Agreements
Registered NaviNet® users who can access the Horizon BCBSNJ plan central page are able to navigate to online copies of Agreements for both Horizon BCBSNJ and Horizon NJ Health Networks. Follow the steps below to navigate to this protected content online.

  1. Log in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu.

  2. Mouse over References and Resources and click Provider Reference Materials.

  3. Mouse over Resources and click Manuals & User Guides.

  4. Click Agreements.

If you have trouble accessing our Agreements online, please review the Horizon BCBSNJ Email Share information in our Credentialing Frequently Asked Questions.

Register with NaviNet
If you don’t have access to NaviNet, we encourage you to register. Visit our website and click Register within the Provider Sign In window. If you don’t have access to the Horizon BCBSNJ link under the My Health Plans menu, access NaviNet and submit a request to have Horizon BCBSNJ added to your profile.

If you still have issues with access, you may email a request for the appropriate Agreement(s) to EnterprisePDM@HorizonBlue.com. It may take up to 10 business days to receive Agreements requested by email.

Published on: August 17, 2020, 05:26 a.m. ET
Last updated on: August 17, 2020, 05:38 a.m. ET