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Organized Delivery Systems
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Certification
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Licensure
  • Application for license - To be completed by entities that will be compensated on a basis that entails the assumption of financial risk, as defined at N.J.A.C. 11:22-4.2.

    Entities that will be compensated on a basis that entails the assumption of financial risk, but this financial risk meets the criteria of de minimus risk, as set forth at N.J.A.C. 11:22-4.3 (b) may be granted an exemption from licensure.   If you are claiming that the financial risk is de minimus, check off on the Application Coversheet that you are applying for “Exemption”, otherwise check off “Licensure.”

  • Contact information for Licensed ODS: June Duggan, (609) 940–7410 or e-mail
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Description of Organized Delivery Systems


An Organized Delivery System (ODS) is a legal entity that contracts with a carrier for the purpose of providing or arranging for the provision of health care services to those persons covered under a carrier’s health benefits plan, but which is not a licensed health care facility or other health care provider.

Examples of the types of entities that are an ODS include preferred provider organizations (PPOs), Physician Hospital Organizations (PHOs) and Independent Practice Associations (IPAs). In order to contract with a carrier, an ODS must become licensed or certified. However, by law, an entity that only contracts to provide pharmaceutical services, or case management services, or employee assistance plan services does not have to become licensed or certified.

Certain additional entities that might otherwise appear to be an ODS also are exempt from obtaining certification or licensing. More details are set forth in regulations.

 
Approved Organized Delivery Systems
 
Licensed
American Specialty Health ODS of New Jersey
10221 Wateridge Circle, San Diego, CA 92121
Telephone: 1-800-848-3555 ashnetworks.com
CareCentrix of New Jersey, Inc.
20 Church St., Suite 1200, Hartford, CT 06103
Telephone: 860-466-7725 carecentrix.com
DentaQuest
465 Medford St., Boston, MA 02129
Telephone: 1-800-417-7140 dentaquest.com
Freedom Health Solutions, LLC
35 Journal Square, Suite 1103, Jersey City, NJ 07306
Telephone: 201-216-9500  
Hackensack Meridian Health Partners, LLC
343 Thornall St., Edison, NJ 08837
Telephone: 1-844-888-4400 hackensackmeridianhealth.org
Healthplex of NJ, Inc.
333 Earle Ovington Blvd., Suite 300, Uniondale, NY 11553-3608
Telephone: 1-800-468-0608 healthplex.com
HN1 Therapy Network of New Jersey
801 E. Halandale Beach Blvd., Hallandale, FL 33009
Telephone: 305-614-0101 hn1therapynetwork.com
LIBERTY Dental Plan of New Jersey, Inc.
340 Commerce, Suite 100, Irvine, CA  92602
Telephone: 1-888-703-6999  
Magellan Behavioral Health of NJ, LLC
8621 Robert Fulton Drive, Columbia, MD 21046
Telephone: 410-953-1000 magellanhealth.com
Optum Networks of NJ, Inc.
1311 Mamaroneck Ave., Suite 240, White Plains, NY 10605
Telephone: 914-681-8800 orthonet-online.com
Prospect Health Services NJ, Inc.
10780 Santa Monica Blvd., Suite 400, Los Angeles, CA 90025
Superior Vision of New Jersey, Inc.
881 Elkridge Landing Road, Suite 300, Linthicum Heights, MD 21090
Telephone: 1-800-243-1401 superiorvision.com
ValueOptions of New Jersey, Inc.
240 Corporate Blvd., Norfolk, VA 23502
Telephone: 757-459-5200 valueoptions.com
 
Certified
Academy Orthotic & Prosthetic Associates IPA, Inc.
2810 Morris Ave., Union, NJ 07083
Telephone: 908-686-3521  
AHS Health Network, LLC
475 South St., Morristown, NJ 07962
Audiology Distribution, LLC d/b/a HearUSA
10455 Riverside Drive, Palm Beach Gardens, FL 33410
Telephone: 1-800-323-3277 hearusa.com
Avesis Third Party Administrators, LLC
10400 North 25th Avenue, Suite 200, Phoenix, AZ 85021-1696
Telephone: 1-800-643-1132 avesis.com
Beech Street Corporation
25500 Commercentre Drive, Lake Forest, CA 92630-8855
Telephone: 949-672-1000 beechstreet.com
Brighton Health Network, LLC
1600 Stewart Avenue, 7th Floor, Westbury, NY 11590
Telephone: 1-888-799-6465 magnacare.com
Brighton Health Plan Solutions, LLC
1600 Stewart Avenue, 7th Floor, Westbury, NY 11590
Telephone: 1-888-799-6465 magnacare.com
CareCentrix®
20 Church St., Suite 1200, Hartford, CT 06103
Telephone: 860-528-4038 carecentrix.com
CareCore NJ, LLC dba eviCore healthcare NJ ODS
169 Myers Corners Road, Wappingers Falls, NY 12590
Telephone: 1-800-918-8924 carecorenational.com
Careington International Corporation
7400 Gaylord Parkway, Frisco, TX 75035
Telephone: 1-800-441-0380 careington.com
Care To Care, LLC
485 Madison Ave., 2nd Floor, New York, NY 10022
Telephone: 212-747-1000 caretocare.com
Carisk Specialty Services, LLC
25A Hanover Road, Suite 201, Florham Park, NJ 07932
Telephone: 973-451-9415 CariskPartners.com
Consumer Health Network Plus, LLC (d/b/a CHN PPO)
300 American Metro Blvd., Suite 170, Hamilton, NJ 08619-1205
Telephone: 1-800-225-4246 chn.com
Davis Vision
711 Troy Schenectady Road, Suite 301, Latham, NY 12110
Telephone: 1-800-999-5431  davisvision.com
Dental Benefit Providers, Inc.
10175 Little Patuxent Parkway, Columbia, MD 21044
Telephone: 1-800-445-9090 dbp.com
Dental Health Alliance
2323 Grand Blvd., Kansas City, MO 64108
Telephone: 1-800-522-1313 dha.com
Dental Network of America, LLC
701 E. 22nd St., Suite 300, Lombard, IL 60148
Telephone: 630-691-1133 dnoa.com
DenteMax Customer Service
25925 Telegraph Road - Suite 400, Southfield, MI 48033
Telephone: 1-800-752-1547 dentemax.com
DentaQuest d/b/a Eyequest
465 Medford St., Boston, MA 02129
Telephone: 1-800-417-7140 dentaquest.com
Ear Professionals International Corp.
11000 Optum Circle MN102-0200, Eden Prairie, MN 55344
Telephone: 1-855-523-9355  uhchearing.com
Envolve Vision, Inc.
1151 Falls Road, Suite 2000, Rocky Mount, NC 27804
Telephone: 1-800-334-3937  
Evernorth Behavioral Health, Inc.
11095 Viking Drive, Suite 350, Eden Prairie, MN 55344
Telephone: 1-800-274-7603 cigna.com
eviCore healthcare MSI, LLC d/b/a eviCore healthcare
730 Cool Springs Blvd., Suite 800, Franklin, TN 37067
Telephone: 1-800-467-6424 evicore.com 
EyeMed Vision Care, LLC
4000 Luzottica Place, Mason, OH 45040
Telephone: 1-866-9-EYEMED eyemedvisioncare.com
First Health Group Corp.
10260 Meanley Drive, San Diego, CA 92131
Telephone: 1-800-247-2898 firsthealth.coventryhealthcare.com
First Look Vision Network, LLC
8485 Goodwood Blvd., Baton Rouge, LA 70806-7878
Telephone: 1-888-400-9304 alwayscarebenefits.com
Government Employees Health Association, Inc. (GEHA)
310 N.E. Mulberry St., Lee’s Summit, MO 64086
Telephone: 1-877-477-6872 geha.com
Integra Partners IPA, LLC
100 Wall St., Suite 2502, New York, NY 10005
Telephone: 718-369-0012 accessintegra.com
IPA of North Jersey
703 Main St., Paterson, NJ 07509-7214
Telephone: 973-754-2795  
Magellan Healthcare, Inc.
8621 Robert Fulton Drive, Columbia, MD 21046
Telephone: 410-953-1000 magellanhealth.com
March Vision Care Group, Inc.
6601 Center Drive West, Suite 200, Los Angeles, CA 90045
Telephone: 1-844-686-2724 marchvisioncare.com
Med-Net IPA, LLC
196 Princeton-Hightstown Road Bldg. 1A, Suite 1A, West Windsor, NJ 08550
Telephone: 609-454-5020  
Fax: 609-454-5021 mednetipa.com
MHN Services, LLC
2370 Kerner Blvd., San Rafael, CA  94901
Telephone: 1-800-327-2133 mhn.com
ModivCare Solutions, LLC
1275 Peachtree Street NE, 6th Floor, Atlanta, GA 30309
Telephone: 1-800-486-7647 ModivCare.com
Morris Area Integrated Physicians, IPA
95 Madison Ave., 4th Floor, Suite 406, Morristown, NJ 07960
Telephone: 973-971-7222  
Morris-Somerset IPA, Inc.
1719 Route 10 East, Suite 303, Parsippany, NJ 07054
Telephone: 973-292-9496  
MultiPlan, Inc.
115 Fifth Ave., New York, NY 10003-1104
Telephone: 212-780-2000 multiplan.com
National Visions Administrators, LLC
1200 Route 46 West, 2nd Floor, Clifton, NJ 07013
Telephone: 973-574-2400  
OptumHealth Care Solutions, LLC
UnitedHealth Group, 11000 Optum Circle, Eden Prairie, MN 55402
  uhc.com
Partnership Healthcare, LLC
107 Monmouth Road, Suite 103, West Long Branch, NJ 07764
Telephone: 732-652-8484 partnershiphealthcare.com
POMAC Metro, LLC
813 East Gate Drive, Suite A, Mount Laurel, NJ 08054
Telephone: 1-800-946-9170 pomacnetwork.com
Private Healthcare Systems, Inc.
115 Fifth Ave., New York, NY 10003-1104
Telephone: 212-780-2000 multiplan.com
Prospect Provider Group NJ, LLC
10780 Santa Monica Blvd., Suite 400, Los Angeles, CA 90025
QualCare, Inc.
30 Knightsbridge Road, Piscataway, NJ 08854
Telephone: 732-562-0833 qualcareinc.com
Radiology Consultants of New Jersey, Inc. (RADCON)
302 Harper Drive, Suite 101, Moorestown, NJ 08057
Telephone: 856-608-1350 radconinc.net
Solstice of New York, Inc.
7901 SW 6th Court, Suite 400, Plantation, FL 33324
Telephone: 1-877-760-2247 solsticebenefits.com
Spectera, Inc.
10175 Little Patuxent Parkway, Columbia, MD 21044
Telephone: 1-800-638-3120 spectera.com
Superior Vision Services, Inc.
881 Elkridge Landing Road, Suite 300, Linthicum Heights, MD 21090
Telephone: 1-800-923-6766 superiorvision.com
Tricenna IPA, LLC
347 Mount Pleasant Ave., Suite 205, West Orange, NJ 07052
Telephone: 862-252-8144      tricenna.com
United Behavioral Health
1900 E. Golf Road, Suite 300, Schaumburg, IL 60173
Telephone: 1-800-711-6089 unitedbehavioralhealth.com
United Concordia Companies, Inc.
1800 Center Street, Suite 2B 220, Camp Hill, PA 17011
Telephone: 1-800-972-4191 ucci.com
U.S. Imaging Network, LLC
733 Third Ave., 11th Floor, New York, NY 10017
  usimagingnetwork.com
Vista Health Systems, LLC
95 Summit Ave., 4th Floor, Summit, NJ 07901
Telephone: 908-598-0101 vistaipa.com
Zelis Network Solutions, LLC
Two Concourse Parkway, Suite 300, Atlanta, GA 30328
Telephone: 404-459-7201 zelis.com
 
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New Jersey Department of Banking and Insurance