Reimbursement / Payment
Election Form - Installment Payments for Maternity Services
Participating and non-participating obstetrical providers use this form to request payment on an installment basis for maternity services rendered during the term of a covered Horizon BCBSNJ member’s pregnancy. ID: 7145
Request Form - Adjustment to Capitation for Multiple People
Use this form to request that Horizon BCBSNJ adjust capitation for multiple people. ID: 2801
Request Form - Adjustment to Capitation for One Person
Use this form to request that Horizon BCBSNJ adjust capitation for one person. ID: 20002
