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Referral Requirements for Services Not Related to COVID-19

At the beginning of the COVID-19 Public Health Emergency (PHE), Horizon waived or relaxed certain administrative requirements related to facility prior authorizations and referrals to help ensure that our members were able to access and obtain appropriate care and services without unnecessary delays or excess burden on providers.

While we are still waiving referral requirements for COVID-related services, providers should continue to submit referrals for all non-COVID-related services for their patients when required by their plan.

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.

    1. From the Horizon BCBSNJ plan central page, mouse over Referrals and Authorization and click Referrals
    2. Click Create New Referral
    3. Locate subscriber/patient
    4. Complete required info
    5. Click Submit
       
  • Submitting Referrals through our IVR System

    Referrals can also submitted by calling at 1-800-624-1110. After submitting a referral using our Interactive Voice Response (IVR) system. Once submitted, you can view and/or print the applicable Referral Confirmation Receipt(s) from NaviNet.net.