New Jersey has one of the densest physician populations in the country and a commercial payer market dominated by Horizon Blue Cross Blue Shield of New Jersey. The state’s Medicaid program (NJ FamilyCare) is run through managed care organizations, and New Jersey has some of the strongest patient protection laws in the nation. Billing correctly here means knowing Horizon’s rules, NJ FamilyCare MCO requirements, and the state’s out of network billing regulations. Go Medical Billing serves NJ practices statewide.
Horizon BCBS of New Jersey
Horizon controls the largest share of New Jersey’s commercial market. Their OMNIA tiered network plan, provider portal, and claims edits require specific knowledge. We process Horizon NJ claims daily and know their system thoroughly.
NJ FamilyCare (Medicaid)
NJ FamilyCare covers over 2 million residents through MCOs including Amerigroup, WellCare, Aetna Better Health, and United. Each has its own enrollment and billing processes. We handle all NJ Medicaid plans.
NJ Out of Network Regulations
New Jersey has strong out of network billing protections under the Out of Network Consumer Protection Act. Combined with the federal No Surprises Act, OON billing in NJ requires careful compliance. Our team handles both.
Starting at 2.49% of collections. NJ billers cost $42,000 to $58,000. Our entire team costs less than one hire.
Call 888 701 6090 for a free New Jersey billing assessment.
