Referral Requirements for All Services
At the beginning of the COVID-19 Public Health Emergency (PHE), Horizon temporarily waived or relaxed certain administrative requirements related to facility prior authorizations and referrals to help ensure that our members were able to obtain appropriate care and services without unnecessary delays or excess burden on providers.
Currently, providers should submit referrals for all non-COVID related services for their patients when required by their plan.
When the PHE ends on May 11, 2023, providers should also submit referrals for services related to COVID-19 as required by their patients’ plans.
All Referrals Are Electronic
Horizon requires that all referrals are created electronically through either NaviNet or our Interactive Voice Response (IVR) system. We do not accept paper referrals.
We encourage providers to review the Referrals section of our Participating Physician and Other Health Care Professional Office Manual for more details.
- Submitting Referrals through NaviNet
Registered users of NaviNet may create, submit and review referrals with just a few clicks of the mouse.
- From the Horizon BCBSNJ plan central page, mouse over Referrals and Authorization and click Referrals
- Click Create New Referral
- Locate subscriber/patient
- Complete required info
- Click Submit
- Submitting Referrals through our IVR System
Referrals can also be submitted by calling 1-800-624-1110. After submitting a referral using our Interactive Voice Response (IVR) system, you can view and/or print the Referral Confirmation Receipt from NaviNet.