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Office of Managed Care Operations
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Quick Reference Guide |
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Telephone Guide |
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Claims Address |
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Empire Blue Bross Blue Shield Website (This link is provided for the convenience of our website visitors. UMDNJ University Hospital takes no responsibility for the information or proprietary of the web sites listed above.) |
Facility/Provider # 310019
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| INPATIENT ADMISSION | Authorization Required by Admitting Physician or Hospital |
| SAME DAY SURGERY |
Authorization Required by Admitting Physician or Hospital |
| OUT PATIENT PROCEDURE |
Authorization Required by Admitting Physician or Hospital |
NOTE: Admitting Physician or Hospital must call to obtain authorization (precertification). Hospital Admitting Department must call Empire Blue Cross prior to admission or surgery to make sure admission or surgery has been authorized.
NOTE: For all Empire Blue Cross patients, please check patients Identification Card to get Precertication Department Telephone #.
| EMERGENCY ROOM VISIT |
No Authorization required. PCP or Hospital must notify Empire Blue Cross within 23-hrs. |
| EMERGENCY ADMISSION | Authorization Required (24-hr notification required by Hospital) |
| DIRECT ADMISSION | Authorization Required (24-hr notification required by Hospital) |
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MENTAL HEALTH/ADMISSION SUBSTANCE ABUSE |
See note below |
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NON EMERGENCY MENTAL HEALTH SUBSTANCE ABUSE |
See note below |
NOTE: For all Mental Health & Substance Abuse please call Merit Behavioral Health. Please see Patients Identification Card for telephone #.
| REFERRAL REQUIRED-OUTPATIENT | PRE AUTHORIZATION REQUIRED-OUTPATIENT | ||||
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NOTE: For All Mental Health & Substance Abuse call Merit Behavioral Health Care. See patient Identification Card for Telephone #.
Provider Representative, Noel Gonzalez 1-888-476-8069
Traditional & Indemnity Provider Relations 1-800-992-2583
HMO & POS Provider Relations 1-800-362-8344
FEP POS Provider Relations 1-800-522-5566
POS Precert Department 1-800-845-4741
FEP POS Precert Department 1-800-255-2042
PPO Precert Department 1-800-982-8089
HMO Precert Department 1-800-441-2411
Electronic Commerce Services (OMNIPRO) 1-315-448-0080
Merit Behavioral Health Care POS 1-800-626-3643
Merit Behavioral Health Care HMO 1-800-635-6626
DRG Review Questions POS & HMO 1-212-476-3908
Retrospective Utilization Review Questions POS & HMO 1-212-476-3857
NOTE: For Accurate Telephone for Provider Relations & Precert Department, Please check patient’s Insurance Card.
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(all information subject to change without notice) |
Last Reviewed:February 2004
All contents copyright © 1997-8
UMDNJ. All rights reserved
All information within this site subject to change without notice.
University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300