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Pensions and Benefits
Behavioral Health Claim Reimbursements Reconsidered

The State Health Benefits Program (SHBP) and School Employees’ Health Benefit Program (SEHBP) Commissions have directed Horizon Blue Cross Blue Shield to reconsider certain out of network claims for professional behavioral health services, reimbursed between May 4, 2009 and March 23, 2014. 

If you received reimbursement for behavioral health claims for services provided by an out of network provider, during the time frame noted, you may be entitled to a reconsideration of your claim.

To pursue adjustment of these claims, you must provide proof that you paid the difference between Horizon BCBSNJ reimbursement and the provider’s full charge.  To request claim reconsideration, complete the form Adobe PDF (88K) and submit it to the address on the form. This form provides specific instructions about the requirements for requesting additional reimbursement along with mailing instructions.    

A separate post office box and telephone number have been created for this process. Be sure to submit complete documentation to the post office box noted on the form.

For questions related to this process, please call Horizon at 1-844-296-1421.

IMPORTANT NOTE:  Requests for reconsideration must be received by December 31, 2014. Requests received after that date will not be considered. 

 

 
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