Blue Cross Blue Shield

How to Get Credentialed with Horizon Blue Cross Blue Shield of New Jersey in New Jersey

Network: Open
30-45 Days CAQH Required

Quick Overview

Timeline

30 - 45 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

New Jersey-Specific Requirements

Horizon Blue Cross Blue Shield of New Jersey. Uses CAQH ProView for credentialing with strong, well-integrated CAQH data flow. Typical processing timeline: 30-45 days — among the FASTEST of all BCBS affiliates due to highly automated credentialing workflow and tight CAQH integration. Requires active New Jersey medical license from the New Jersey State Board of Medical Examiners. DEA registration and New Jersey CDS (Controlled Dangerous Substances) registration required. Board certification required for specialists. Horizon BCBS is the largest health insurer in New Jersey, serving approximately 3.8 million members. Delegated credentialing available through larger medical groups and health systems. Re-credentialing every 3 years.

Step-by-Step Enrollment Process

1

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.

2

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.

3

Submit Your Application

Submit your completed enrollment package to Horizon Blue Cross Blue Shield of New Jersey.

4

Track & Follow Up

Credentialing typically takes 30-45 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

5-year work history minimum; gaps > 6 months must be explained

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

3 peer references required

Enrollment Forms

CAQH ProView

Universal credentialing application used by most commercial and BCBS payers.

Required
Online Open →

Horizon NJ Provider Enrollment

Required
Online Open →
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