Our Take: Insuring more New Jersey residents is critical to ensure ready access to healthcare services and help healthcare consumers establish a “medical home.” But the insurance industry is exceedingly complex, especially with ongoing changes through the Affordable Care Act. Plan redesign poses many challenges for providers, and many questions for consumers.

The following information provides valuable resources and information that will help you understand what rules insurers must follow when reviewing the medical necessity of care, processing claims, making payments and your rights as a provider if the rules are being broken.

NJHA has developed a series of consumer insurance guides to help patients and families navigate the changing world of healthcare insurance. View the Putting the Pieces Together series.

• Federally Facilitated Marketplace
• Managed Care
• Medicaid Managed Care
• Medicare
• Self-Funded