![]() ![]() Each health plan is rated based on the quality of care their members receive (HEDIS®), how happy enrollees are with their care (CAHPS®), and health plans’ efforts to keep improving (NCQA Accreditation standards). The National Committee for Quality Assurance (NCQA) updates a report card for New Jersey health plans. SKYGEN USA administers dental services for Horizon NJ Health members and coordinates all precertification for the provision of inpatient dental care. New Jersey FIDE SNP Model MIPPA Contract (PDF File) Paper dental claims can be mailed to: SKYGEN USA. The public is invited to view the current NJ Famil圜are Managed Care Contract. Managed care health plans are also able to provide a comprehensive package of preventive health services that, combined with the full range of Medicaid benefits, allows for the best healthcare possible. Through managed care, New Jersey beneficiaries have better access to healthcare providers and care coordination than they would have through Medicaid's traditional fee-for-service program. Under managed care, beneficiaries enroll in a health plan or managed care organization (MCO) which coordinates their members' healthcare and offers special services in addition to the regular NJ Famil圜are Medicaid benefits enrollees receive.įive health plans (also known as MCOs) participate in New Jersey's NJ Famil圜are Medicaid program. Horizon Blue Cross Blue Shield of New Jersey PO Box 10138 Newark, NJ 07101-9633. 1-80 (TTY call 711) Medicare Prescription Drug Plan Members. In 1995, New Jersey began moving Medicaid beneficiaries from a traditional fee-for-service health coverage program, where providers bill Medicaid directly, to managed care. Horizon Blue Cross Blue Shield of New Jersey Three Penn Plaza East Newark, New Jersey 07105. ![]()
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