Changes to the Online Utilization Management Request Tool

Horizon BCBSNJ has updated the online Utilization Management Request Tool for an improved user experience. The new design will allow you to easily and securely perform all the same self-service functions through NaviNet®, plus you are now able to submit appeals for denied authorizations and referrals (pre-determination) requests using the tool.

Use the online Utilization Management Request Tool to:

• Submit authorization requests
• Submit referral (pre-determination) requests
• Verify the status of previously submitted authorization or referral (pre-determination) requests
• New: Appeal denied authorizations and referrals (pre-determination) requests

Learn about the changes to the online Utilization Management Tool

Sign in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu.

• From the Workflows for this Plan section, mouse over References and Resources and select Provider References Materials.
• Mouse over Policies & Procedures and select Utilization Management.
• Select Utilization Management Request Tool.
• Scroll down and select Learn How to Use the Utilization Management Request Tool.

How to access the tool

Sign in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu.

• Mouse over Referrals and Authorization.
• Select Utilization Management Requests