Inquiries, Complaints and Appeals
We’re dedicated to giving you access to quality health care and service.
Your plan offers inquiry, complaint and appeal processes designed to provide a prompt response and resolution to all requests, including:
- Medical issues
- Our utilization management decision making
- Other nonutilization management issues
If you are dissatisfied with any aspect of your health plan, you, a doctor or other health care professional or authorized representative, acting on your behalf (and with your consent), may file an inquiry, complaint or appeal with Horizon BCBSNJ. Call Member Services at 1-800-355-BLUE (2583). If you use TTY services, please call 711. Or, you may write to us:Horizon Blue Cross Blue Shield of New Jersey
PO Box 820
Newark, NJ 07105-0820
You may also contact a Member Services Representative by signing in and using the Email Us or Chat tools.
Please send your member appeal, with all supporting documents to:Appeals Department
Horizon Blue Cross Blue Shield of New Jersey
PO Box 317
Newark, NJ 07105-0317
Remember to include your Horizon BCBSNJ member ID number, full name and contact information on all documents.
No member or doctor, or other authorized representative, who makes an inquiry, files a complaint or pursues an appeal will be subject to disenrollment, discrimination or penalty by Horizon BCBSNJ.
Results of Independent Satisfaction Surveys
You can get results of independent consumer satisfaction surveys and analysis of quality outcomes for health care services provided under managed care plans in New Jersey. Call 1-609-292-7272 or mail your request to:Actuarial Bureau
Department of Banking and Insurance
PO Box 325
Trenton, NJ 08625