Becoming a Medicaid/NJ FamilyCare Provider
March 03, 2021
Health Insurance and Autism Series.
Information for Providers
As of April 1, 2020, NJ FamilyCare covers ABA services for children birth to 21 years, a much anticipated benefit for children on Medicaid. Read Medicaid’s announcement for additional details. This article provides information about how providers can enroll to offer this important benefit.
Are you a family? Learn more about accessing this benefit>>
Waiting too long for ABA for your child to begin? Learn more about prompt access to treatment>>
Provider agencies that are not currently approved Medicaid/NJ Family Care providers must do the following:
STEP 1: Obtain a Medicaid Provider Number
STEP 2: Contact the MCOs to complete their contracting process
Both steps can be done simultaneously, but please be aware that the contracting process with the MCOs may need to pause until the Medicaid Provider ID number is obtained.
Obtaining a Medicaid Provider Number
Mail: Gainwell Provider Enrollment, P.O. Box 4804, Trenton, NJ 08650
Inquiries related to completion of the application and addendum may be directed to Gainwell Provider Enrollment at 609.588.6036.
For any questions or concerns about this benefit, providers should call 609.599.8522 or email MAHS.ASDinquiries@dhs.nj.gov.
Contact the MCOs to complete their contracting process
Each MCO has its own requirements. Please inquire directly at the numbers listed below:
Behavioral Health Administrator
Behavioral Health Network Relations
Consultant, Provider Experience
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Library of Amerigroup Forms
For Claim Status and Explanation of Payment Remittances, access the secure provider portal or call 800.454.3730.
For Utilization Management: (escalations only)
Behavioral Health Administrator:
For Billing Concerns:
Nadine Assouman, Provider Resolution Analyst
|Contracting and Billing:
Specialty Network Manager
|Contracting Provider Relations:
O: 973.274.2141 | C: 862.229.4132
O: 973.274.2166 | C: 862.240.2495
Currently serving children through DCF/CSOC/PerformCare?
For providers already contracted with an MCO, the provider needs only to seek an authorization to provide and bill for ABA services. For those who are not contracted with an MCO, the provider must contact their client’s MCO to inquire about becoming credentialed or request a single case provider agreement for their client.
We’re Here for You
Autism New Jersey continues to work closely with Medicaid and CSOC/PerformCare on this benefit. If you have questions, concerns, or feedback, please contact firstname.lastname@example.org.
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Originally posted 4/21/2020