Need help with the Provider Express secure portal?
The Technical Support team is available by chat or by calling
1-866-209-9320.
New Jersey Medicaid ABA Program
A streamlined way for all ABA providers to manage services
Both network and out-of-network providers manage ABA services in the Provider Express secure portal. A One Healthcare ID (OHID) is required to access the portal.
The self-paced guide provides step-by-step instructions for how to register for a One Healthcare ID and access the portal for the first time.
Use the Provider Express secure portal to:
- Verify ABA Coverage and eligibility
- Request ABA assessment and treatment authorizations
- Submit additional information to the clinical team upon request
- View real-time status updates on your requests
Prior Authorization requests
UnitedHealthcare Community Plan is one of the selected managed care plans providing coverage to New Jersey FamilyCare members. Optum has been selected by UnitedHealthcare Community Plan to develop and manage the ABA network for New Jersey FamilyCare members, effective 4/1/2020. Your participation in our network helps to ensure access to comprehensive quality care for covered behavioral health services for enrolled members.
To assist you in your participation in this program, learn more about the process for applying to the network, and the clinical protocols required in this unique network, please review the resource materials below
Prepare your prior authorization request
Refer to our submission checklist QRG to ensure you have all the required information. A complete submission helps prevent processing delays.
- Review the ABA clinical review requirements
- Provider data: Name, address, NPI and TIN
- Member data: Name, address and Member ID*
Use these self-paced guides to learn how to:
Verify ABA eligibility and benefits
Submit an ABA prior authorization request
Get the status of submitted ABA authorization requests
Submit an authorization request in 5 steps
1. Select 'Auths' from the upper right menu
2. Click the 'Auth request' tab
3. Choose 'Request a new authorization'
4. Select ABA Assessment or Treatment from the drop down
5. Complete the required fields and submit
- New Jersey FamilyCare Medicaid ABA Orientation
- NJ ABA QRG (updated version 4.26.21)
- DMAHS Guide to Autism Services
Developmental Services
Effective July 1, 2020 the Division of Medical Assistance and Health Services (DMAHS) launched coverage for the provision of Developmental Services to support families with children diagnosed with Autism Spectrum Disorder (ASD). For the purposes of eligibility, these services are available to any NJ FamilyCare/Medicaid (NJFC/M) eligible child, under the age of twenty-one, who has been diagnosed with ASD, as defined by ICD-10 diagnosis codes F84.0 through F84.9, by a qualified healthcare provider.
- New Jersey FamilyCare Medicaid DIR Orientation (updated version 4.26.21)
- NJ DRBI QRG (updated version 4.26.21)
Contact Us/Request to Join the Network
Call Provider Relations at 1-877-614-0484.
