With over 35 years of experience in New Jersey, our parent company Medlogix and CHN PPO are deeply rooted in the state's challenging insurance landscape.
New Jersey is among the most complex and highly regulated states to navigate claims management. Our experience in New Jersey and other demanding state environments helped us develop highly sophisticated solutions that can be applied seamlessly in other markets.
Our success in these challenging regulatory states paved the way for our national expansion.
Our extensive regional and nationwide network of physicians provides our clients with thousands of state-specialty combinations to match their cases.
CHN PPO’s network includes over 228,000 provider locations, with a strong concentration in New Jersey
- CHN PPO serves insurance carriers, TPAs, Joint Insurance Funds, counties, municipalities, and school boards in New Jersey.
- CHN PPO’s providers are thoroughly vetted and credentialed, with state-specific compliance standards to minimize regulatory risk in New Jersey.
- The New Jersey Voluntary Provider Network focuses on high-cost procedure management and specialized care.
CHN PPO’s Certifications & Regulatory Approvals in New Jersey
- Organized Delivery System (ODS) in New Jersey.
- Workers’ Compensation Managed Care Organization (WCMCO) in New Jersey.
- CHN PPO operates a New Jersey Voluntary Provider Network, included as part of its specialty network offerings.
Claims & Bill Review Services in NJ
- CHN PPO’s MyMedlogix system is designed for full integration with New Jersey claims workflows.
- MyMedlogix applies state-specific fee schedules prior to the PPO rate application process.
- For out-of-network claims, CHN PPO and Medlogix use bill negotiation services that utilize UCR, Medicare benchmarks, and utilization history to reduce costs.
- Signed Letters of Acceptance (LOAs) are required and retained for each negotiated bill.
We are the first company in New Jersey to have their plan approved by the NJ Department of Banking and Insurance, a testament to our pioneering approach and dedication to compliance.
- Our senior executives actively advise the NJ PIP TAC Committee.
- Medlogix has provided training and guidance to insurance carriers, regulators, arbitrators, and providers on compliance and best practices.
- We offer a full complement of NJ Precertification Services within AICRA regulations and carrier plan specific rules approved by the NJ State Department of Banking and Insurance.
FREQUENTLY ASKED QUESTIONS
CHN PPO offers national access through direct contracts and affiliate partnerships, with strong provider concentrations in NY, PA, CT, MA, NH, VT, and RI.
CHN PPO New Jersey | Preferred Provider Organization
CHN PPO Group Health offers employer groups an affordable healthcare solution through a network of over 228,000 providers, featuring real-time claims management. Key features include cost mitigation with fixed-rate contracts, a comprehensive provider network, add-on services like pre-certification and case management, and a customizable platform with integrated MyMedlogix software. The service emphasizes a patient-centered approach with experienced medical staff, ensuring quality care and medical expense control. Group health services encompass pre-certification, utilization management, large case management, medical bill auditing, bill negotiations, and field case management.
Where to find us:
Consumer Health Network
300 American Metro Blvd Suite 220, Hamilton Township, NJ 08619, United States
Directions from nearest airport:
Trenton-Mercer Airport
1100 Terminal Cir Dr, Ewing Township, NJ 08628, United States
Get on I-295 S in Hopewell Township from Sam Weinroth Rd
5 min (2.0 mi)
Follow I-295 S to Sloan Ave in Hamilton Township. Take exit 65A-65B from I-295 S
8 min (8.2 mi)
Continue on Sloan Ave to your destination
3 min (1.0 mi)
Consumer Health Network
300 American Metro Blvd Suite 220, Hamilton Township, NJ 08619, United States
About New Jersey
New Jersey, located in the northeastern United States, is known for its diverse landscape, from Atlantic Ocean beaches to rolling hills and forests. It is densely populated and a major hub for commerce, industry, and transportation. Key characteristics include its strong economy, proximity to New York City and Philadelphia, and numerous historical sites and cultural attractions.
Popular Landmarks in New Jersey
1. Atlantic City Boardwalk
A historic boardwalk featuring casinos, shops, restaurants, and amusement piers along the Atlantic Ocean.
2. Liberty State Park
Offers views of the Statue of Liberty, Ellis Island, and the Manhattan skyline, with walking paths and ferry access.
3. Cape May
A Victorian seaside resort town known for its historic architecture, beaches, and birdwatching opportunities.
4. Princeton University
Home to a prestigious university with historic buildings, gardens, and museums open to the public.
5. Delaware Water Gap National Recreation Area
A scenic area with hiking trails, waterfalls, and opportunities for kayaking and canoeing on the Delaware River.
6. Grounds For Sculpture
A 42-acre sculpture park and museum with contemporary sculptures set in landscaped gardens.
7. Six Flags Great Adventure
An amusement park featuring roller coasters, thrill rides, and a safari park.
8. Montclair Art Museum
Showcases American and Native American art, with a focus on the cultural heritage of the region.
9. Battleship New Jersey
A retired US Navy battleship open for tours, providing insight into naval history.
10. Paterson Great Falls National Historical Park
Features a historic industrial site and a dramatic waterfall on the Passaic River.
More information:
What is PPO Billing?
CHN PPO Group Health offers real-time claims management. Key features include cost mitigation with fixed-rate contracts, a comprehensive provider network, and a customizable platform. The service focuses on medical expense control.
What is PPO?
A Preferred Provider Organization (PPO) is a type of health insurance plan that allows members to seek medical care from doctors, hospitals, and other healthcare providers within a specific network. Unlike Health Maintenance Organizations (HMOs), PPOs typically do not require members to choose a primary care physician (PCP) or obtain referrals to see specialists. This flexibility allows members to access a wider range of healthcare services without the need for prior authorization, although seeing in-network providers usually results in lower out-of-pocket costs.
Is PPO better than HMO?
PPO plans offer more flexibility, allowing you to see specialists without referrals and choose out-of-network providers, though at a higher cost. HMO plans are typically more affordable with lower premiums and out-of-pocket expenses, but they require you to select a primary care physician and obtain referrals for specialists. The "better" choice depends on individual needs and preferences regarding cost, flexibility, and provider selection.
Similar Keywords:
- Preferred Provider Organization
- Health Insurance Plan
- Healthcare Network
- Medical Providers
- Insurance Coverage
- Managed Care
- Network Providers
- Out-of-Network
- In-Network
- Medical Benefits
Cities in NJ
Atlantic City, Jersey City, Newark, Trenton, Hoboken, Elizabeth, Paterson, Edison, Woodbridge, and Camden
Zip Codes in NJ
07001, 07002, 07003, 07004, 07005, 07006, 07007, 07008, 07009, 07010
Neighborhoods in NJ
Atlantic City, Jersey City, Newark, Trenton, Hoboken, Elizabeth, Paterson, Edison, Woodbridge, and Camden.