Mental Health and Substance Abuse Services

Behavioral Health is a Managed Care benefit. This means that you must call the Fund Office to obtain authorization BEFORE you receive treatment, except for when you receive outpatient treatment with a non-participating provider.

The network of participating providers for behavioral health is different from those for medical services. You cannot search for Mental Health participating providers on the Blue Cross Blue Shield website or the NJC Fund website. The behavioral health network of participating providers is private, accessed only by the staff of the NJC Fund Behaviroal Health Department.

Finding a Provider

If you or your eligible dependents need counseling/mental health services or if someone has a problem with alcohol or substance abuse, the NJC Fund has a designated, confidential phone line to assist our members. Call 1-732-417-0300. All phone calls are handled with strict confidentiality.

If you call during business hours, a licensed psychologist will help you determine what type of treatment would best serve you and assist you in finding participating providers in your area to suit your particular needs. If you prefer not to receive personal assistance, and would like a provider list mailed or faxed to you, please leave the following information on the above voice mail: your name, your member ID#, your address and/or fax, counties where you would seek services, and any special needs you have (child/adolescent provider, specialty area).

Note: In addition to outpatient therapy and psychiatric treatment, the behavioral health network includes services for more intensive psychiatric treatment (inpatient, partial hospitalization, and intensive outpatient programs) and all types of substance abuse treatment (inpatient detoxification and rehabilitation, intensive outpatient programs). To access these services, you must speak with the behavioral health department.

Authorization:

NJCF must be notified of the beginning of any treatment so that we can initiate authorization. Call 732-417-0300 x2 with the patients name, ID#, name of treating provider and the beginning date of service.

Benefits:

Level 1 covers inpatient treatment only, outpatient services only for Level 2 or 3.

All approved treatment at a participating facility is covered in full for the following services: inpatient mental health, inpatient detoxification, inpatient rehab for substance abuse, partial hospitalization, and intensive outpatient services. Substance abuse admissions are limited to two admissions per individual per lifetime regardless of whether detoxification is done on an inpatient or outpatient basis.

Psychotherapy is covered at 80% of the fee schedule. Out of pocket expense is minimized by using in-network providers. Medication treatment with a psychiatrist is also covered at 80% of the fee schedule, however when out-of-network, is subject to the deductible.