Official Site of The State of New Jersey
General BH Integration Information and Materials
- Behavioral Health Integration Provider Guidance Packet (04/25/2025)
This document offers detailed program guidance for current and prospective providers with NJ FamilyCare who provide or are seeking to provide behavioral health services. - DMAHS BH Provider Phase 1 Implementation FAQs
This document answers most frequently asked questions from provider trainings, office hours, and other communications regarding enrollment & credentialing, prior authorization, and claims & billing. - 04/23 DMAHS and MCO Virtual Office Hours for Providers
This is the presentation from the 04/23 DMAHS and MCO Virtual OH for providers, which includes answers to frequently asked questions and detailed BH Integration and MCO-specific guidance.
MCO Contact Information
For member specific inquiries and MCO-related questions, please contact the member's MCO. Providers can find the MCO points of contact in the DMAHS BH Integration Points of Contact.
MCO Provider Manuals
Each MCO has provider manuals that serves as a resource for providers and outlines policies and operations for each of the health plans:
DMAHS Contact Information
If providers cannot reach a resolution after visiting the website or outreaching the MCOs, they should contact either the DMAHS Office of Managed Health Care (OMHC) or the Behavioral Health Unit based on their specific needs or inquiry.
If your issue is related to contracting & credentialing, claims & reimbursement, or prior authorizations, please reach out to OMHC at mahs.provider-inquiries@dhs.nj.gov. If your issue is related to policies & guidelines, access to services, or general questions, please reach out to the BH Unit at dmahs.behavioralhealth@dhs.nj.gov. When you reach out to request further assistance, please include all relevant and specific details regarding your issue.
DMAHS BH Integration: Provider Enrollment and Credentialing Training (September 2024)
Annotated Enrollment Templates:
- 21st Century Application
- FFS Psychologist Group
- Enrollment and Credentialing Webinar Recording
- Provider Enrollment and Credentialing FAQs (10/28/2024)
Additional enrollment contact information
For questions related to NJMMIS, provider should reach out to Gainwell:
- Address: Gainwell Technologies Provider Enrollment, P.O. Box 4804, Trenton, NJ 08650
- Email: njmmisproviderenrollment@gainwelltechnologies.com
- Fax: 1-609-584-1192
- Phone: 1-609-588-6036
Managed Care Prior Authorization Guidance for Phase 1 Mental Health Services
- This document offers comprehensive guidance on the managed care prior authorization process for BH Integration Phase 1 Mental Health services
Managed Care Prior Authorization Guidance for Phase 1 Substance Use Disorder Services
- This document offers comprehensive guidance on the managed care prior authorization process for BH Integration Phase 1 Substance Use Disorder (SUD) services.
DMAHS BH Integration: Provider Mental Health (MH) Prior Authorization Guidance and Medical Necessity Training (September 2025)
- Provider Mental Health (MH) Prior Authorization Guidance and Medical Necessity Training Presentation
- Provider Mental Health (MH) Prior Authorization Guidance and Medical Necessity Training Recording
DMAHS BH Integration: Provider Substance Use Disorder (SUD) Prior Authorization Guidance and Medical Necessity Training (September 2025)
- Provider Substance Use Disorder (SUD) Prior Authorization Guidance and Medical Necessity Training Presentation
- Provider Substance Use Disorder (SUD) Prior Authorization Guidance and Medical Necessity Training Recording
DMAHS BH Integration: Provider Prior Authorization Refresher Training (March 2025)
- Provider Prior Authorization Refresher Training Presentation
- Provider Prior Authorization Refresher Training Recording
- Provider Prior Authorization Refresher Training FAQs
DMAHS BH Integration: Provider Prior Authorization Training (November 2024)
- Provider Prior Authorization Refresher Training Presentation (11/26/2024)
- Provider Prior Authorization Refresher Training Recording
- Provider Prior Authorization Refresher Training FAQs (11/26/2024)
DMAHS BH Integration: NJSAMS Training (November 2024)
- Provider NJSAMS Presentation (12/03/2024)
- NJSAMS Training Recording (11/27/2024)
- NJSAMS Tutorial Video
SUD prior authorization and NJSAMS contact information
- IME
Providers should contact the IME for process related issues (e.g., unsure how to complete an NJSAMS admission file):
Email: imeum@ubhc.rutgers.edu
Phone: 1-844-276-2444 - MCO Contact Information
Providers should contact a member’s MCO for issues related to MCO communication regarding SUD prior authorizations. Providers can find the MCO points of contact in the DMAHS BH Integration of Contact document. - NJSAMS ticket
Providers should submit an NJSAMS ticket when experiencing technical issues. To access the NJSAMS ticket system, log in to NJSAMS, navigate to the Help Menu, and select option for Ticket Management.
DMAHS BH Integration: Provider Claims Refresher Training (February 2025)
- Provider Claims Refresher Training Presentation
- Provider Claims Refresher Training Recording
- Provider Claims Refresher Training FAQs
DMAHS BH Integration: Provider Claims Training (October 2024)
- Provider Claims Training Presentation
- Provider Claims Training Webinar Recording
- Provider Claims Training FAQs
- MCO MH Partial Care Transportation
This document offers detailed guidance on how providers should bill for MH partial care transportation with each MCO.
DMAHS BH Integration: Provider MCO Care Management Training (January 2025)
- Provider MCO Care Management Training Presentation
- Provider MCO Care Management Training Recording
- Provider MCO Care Management Training FAQs (02/06/2025)
Care management referral contact information
To refer members to MCO-led integrated care management, providers should reach out to a member’s MCO:
- Aetna: Refer members via
Email at aetnabetterhealthNJCMReferral@aetna.com or
Phone at 1-855-232-3596 - Fidelis Care: Refer members via
Email at david.houston@fideliscarenj.com
Phone at 1-973-856-1151 - Horizon: Refer members via
Phone at 1-800-862-9094 or
Visit the website to complete the Care/Case Management Referral Form - UnitedHealthcare: Refer members via
Email at necsbhcca@uhc.com or
Phone at 1-877-704-8871 - Wellpoint: Refer members via
Email at NJBehavioralHealth@Wellpoint.com