Nj direct claim form 2025

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The NJ DIRECT Claim Form is a document for members of the New Jersey State Health Benefits Program to submit claims for medical expenses. It requires detailed subscriber and patient information, including identification numbers, health coverage details, and authorization for processing claims. The form also outlines necessary documentation, such as itemized bills and coordination of benefits with other insurance plans. Additionally, it provides instructions on where to submit the completed claim forms and includes a fraud warning.

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Is Horizon NJ Direct a Medicaid?

Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health℠, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association.

What is the difference between NJ Direct 10 and 15?

NJ DIRECT15 provides reimbursement for out-of-network coverage at 70 percent of the reasonable and customary fee schedule after deductible for most services, while NJ DIRECT10 (FOR RETIREES) provides reimbursement for out-of-network coverage at 80 percent of the reasonable and customary fee schedule after deductible,