Is your doctor recommending spinal surgery?
As a reminder, on November 1, 2016, Horizon BCBSNJ expanded our collaboration with eviCore healthcare for prior authorization and/or medical necessity determination review of certain spine surgery services. This new process focuses on ensuring you receive the right care at the right time.
Spine surgery services are now reviewed either pre- or post-service to:
- Determine medical necessity;
- Ensure the surgery is performed at the appropriate site of service; and
- Ensure appropriate conservative therapies are attempted prior to invasive procedures.
If you need or may need spinal surgery services, ask your doctor to coordinate with Horizon BCBSNJ for pre-service review.
eviCore healthcare supports Horizon BCBSNJ in the administration of Horizon's health care program. eviCore healthcare is independent from and not affiliated with Horizon BCBSNJ or the Blue Cross Blue Shield Association.