MedicaidAdministrativeHigh impact
Newsletter Vol. 12, No. 34
New Jersey Medicaid·NJ·Provider Notice
Effective date
May 1, 2002
We identified it
Jun 20, 2026
Summary
Effective May 1, 2002, New Jersey's Medicaid program will begin auto-assigning Aged, Blind, and Disabled (ABD) beneficiaries who have not voluntarily selected an HMO into mandatory managed care plans, starting in Camden County. Providers must verify HMO network participation to continue serving these patients, as only in-network providers can bill for Medicaid-enrolled beneficiaries.
Action Required
REQUIREMENTS:
- By April 8, 2002: Verify which of the five Medicaid-contracted HMOs (AmeriChoice, AMERIGROUP, Health Net, Horizon Mercy, University Health Plans) your practice participates in. Contact provider services for each plan to confirm active network status.
- By May 1, 2002: Billing team must update patient records and billing system to identify ABD beneficiaries and their assigned HMO plans. Verify eligibility before processing claims.
- Immediately: Notify front desk and scheduling staff to inform patients verbally and in writing of their HMO plan assignment, and provide contact information for the five HMOs listed in the newsletter.
- Ongoing: When ABD patients call requesting HMO changes, inform them that transfers take approximately 45 days to process. Direct them to call the Health Benefits Coordinator at 1-800-356-1561 or the HMO member services lines provided.
- Ongoing: For any questions about managed care requirements or exemption processes, direct patients and staff to call the managed care hotline at 1-800-356-1561.
- Consequence of inaction: Claims submitted for ABD patients enrolled in HMOs where your practice is not in-network will be denied. Patients may be unable to access services or may face out-of-pocket costs.