Join a Horizon BCBSNJ or Horizon NJ Health Network
To be considered for participation in one of more of our networks, we must review your credentials and ensure that you meet all criteria for participation. Click the appropriate selection below for detailed instructions and to access all the required information you must provide to be considered for participation in our networks.
- Requirements for Office-Based Physicians
MDs and DOs (including psychiatrists) who are affiliated with an office-based practice should complete this form and submit it to us along with all identified additional information.
- Requirements for Hospital-Based Practitioners
All practitioners (including behavioral health practitioners) who are affiliated only with a hospital-based practice should complete and submit this form.
- Requirements for Other Health Care Professionals
Other Healthcare professionals and behavioral health practitioners (who are not MDs or DOs) should complete this form and submit it to us along with all identified additional information.
ALREADY PARTICIPATING IN A NETWORK?
Already participating practitioners who are seeking to join another network only need to mail the information noted below to:
Horizon BCBSNJ Credentialing/Recredentialing Dept.
3 Penn Plaza East, PP-14C
Newark, NJ 07105-2200
If you are already participating in the Horizon NJ Health networks and wish to join the Horizon Managed Care Network and Horizon PPO Network, please ensure your CAQH information has been recently updated and attested to and provide the following:
- Completed and signed Agreement(s)
If you are already participating in the Horizon Managed Care Network or Horizon PPO Network and wish to join the Horizon NJ Health networks, please ensure that your CAQH information has been recently updated and attested to and provide the completed copies of:
- A signed Agreement
- Provider Network Special Needs Survey
- Americans with Disabilities ACT (ADA) Provider Survey
As we only require one completed ADA survey per practice location, we recommend checking with your office manager to see if a copy has been previously submitted.
Review our Credentialing Frequently Asked Questions.
We encourage you to use CAQH’s provider data-collection service, CAQH ProView™ to make the majority of required information available to us. If you don’t already have a CAQH ProView Profile, please visit https://proview.caqh.org/pr to self-register to obtain your unique CAQH Provider ID number.
If you don’t want to use CAQH, you may complete and submit a copy of the NJ Universal Physician Application. A print application may increase the processing time of your application.
Signed copies of our Provider Agreements must be submitted along with all other required information.
- All Horizon BCBSNJ and Horizon NJ Health Provider Agreements are available online to NaviNet users who have access to the Horizon BCBSNJ plan central page. Log in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu. Then:
- Mouse over References and Resources and click Provider Reference Materials.
- Mouse over Resources and click Manuals & User Guides, and then click Agreements.
- If you don’t have access to the Horizon BCBSNJ page on Navinet, please email a request for the appropriate Agreements to EnterprisePDM@HorizonBlue.com.
SUBMISSION OF INFORMATION
Please mail completed forms with all identified additional information (as applicable) to the address below. Information cannot be submitted to us via email or fax.
3 Penn Plaza East, PP-14C
Newark, NJ 07105-2200
OUR CREDENTIALING PROCESS
Our Credentialing/Recredentialing Department will send a written notice that they received sufficient information to begin the credentialing process. If all required information is not included, the application will be withdrawn and you will have to submit a new application.
Practice Location Effective Dates
Review the table below to understand how we handle applications that include a future practice location effective date.
|If a future practice location effective date is ...||Then that application ...|
|Greater than 90 days||Will be withdrawn and not processed.|
|Less than, or equal to, 90 days||Will be processed through our credentialing process. However, if approved, information about the practitioner will not be displayed in our online Provider Directory until the effective date of participation and following validation via phone outreach.|
The credentialing process takes approximately 90 days from the date that we receive all required information. You will receive a written response if your application has been approved or denied.
Once approved by the Horizon BCBSNJ Credentialing Committee, you will receive a letter that includes your participation effective date, instructions to access a welcome kit of important information and copies of the fully executed Provider Agreement(s).