How to Get Credentialed with Horizon Blue Cross Blue Shield of New Jersey in New Jersey
Quick Overview
Timeline
30 - 45 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
No
How Horizon Blue Cross Blue Shield of New Jersey Credentialing Actually Works
Verified July 2026Apply Through
Timeline
Up to 90 days from the date Horizon has all required information
Recredentialing
Every three years
Horizon breaks the usual Blues pattern: provider survey, document prep (CV, license, DEA certificate, Horizon forms), upload, and submit through Horizon's own tool. CAQH is not the application vehicle here, and Availity handles transactions only. Track progress with your NPI and Submission ID.
Behavioral health routing: Behavioral health is in house through Horizon Behavioral Health, with its own provider services line, (800) 682-9091.
The stall to avoid: The tool times out after 60 minutes of inactivity and makes you start the survey over. Some specialties, including licensed mental health counselors and neuropsychologists, cannot use the tool at all and must mail a paper application. Discrepancy notices require corrections within 14 calendar days.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
New Jersey-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for New Jersey.
Complete Your CAQH ProView Profile
Horizon Blue Cross Blue Shield of New Jersey requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to Horizon Blue Cross Blue Shield of New Jersey.
Track & Follow Up
Credentialing typically takes 30-45 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Horizon Blue Cross Blue Shield of New Jersey?
Our specialists handle the entire Horizon Blue Cross Blue Shield of New Jersey enrollment process: applications, follow-ups, and approvals in New Jersey.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
5-year work history minimum; gaps > 6 months must be explained
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
3 peer references required
Enrollment Forms
Free Tools for Your Horizon Blue Cross Blue Shield of New Jersey Enrollment
NPI Number Lookup
Verify your NPI number before applying to Horizon Blue Cross Blue Shield of New Jersey
Timeline Estimator
Estimate credentialing timeline for Horizon Blue Cross Blue Shield of New Jersey in New Jersey
Readiness Checker
Check if you're ready for Horizon Blue Cross Blue Shield of New Jersey enrollment
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Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- Fee Schedule
- A complete listing of fees and reimbursement rates that an insurance payer will pay for specific medical services and pr...
- HMO
- A Health Maintenance Organization is a managed care plan that typically requires members to choose a primary care physic...
- Network Status
- A provider's participation status with a specific insurance payer, indicating whether they are in-network (contracted) o...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- PPO
- A Preferred Provider Organization is a managed care plan that offers a network of contracted providers at lower costs to...
Credentialing Checklist
Make sure you have everything ready before applying to Horizon Blue Cross Blue Shield of New Jersey.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National1-800-414-7427
Mon-Fri 8am-5pm
Provider Services
National1-800-414-7427
Claims & Billing
National1-800-414-7427
Need Help?
Let PayerReady handle your Horizon Blue Cross Blue Shield of New Jersey enrollment in New Jersey.
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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.