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Introducing the Provider Data Maintenance Tool: a new way to update your demographic information

Having the most current and accurate provider information in our Doctor & Hospital Finder helps our members make informed decisions about getting the care they need. To make it easier for you to update demographic information which displays online, we have developed a new Provider Data Maintenance Tool.

Using this new online tool you can quickly and conveniently make changes to your provider information which we display to your Horizon BCBSNJ and Horizon NJ Health patients:

  • Add or delete office locations
  • Add or update office email addresses
  • Update phone and fax numbers
  • Manage practice limitations
  • Manage areas of expertise for behavioral health services
  • Indicate if you offer telemedicine services

How to access the Provider Data Maintenance Tool

Your NaviNet Security Officer can sign in to NaviNet to access the Provider Data Maintenance Tool through the Horizon BCBSNJ Plan Central page. If you don’t have access to NaviNet, you can sign up for free with your Federal Tax ID.

If you don’t have access to the Horizon BCBSNJ plan central page, access NaviNet and submit a request to have Horizon BCBSNJ added to your profile.

Please continue to email network terminations, TIN changes or practice name changes to EnterprisePDM@HorizonBlue.com.

Why accurate demographic information is so important

  • The Centers for Medicare & Medicaid Services (CMS) requires Horizon BCBSNJ to maintain accurate provider data at all times.
  • To comply with this CMS requirement, we do not display information in our Doctor & Hospital Finder that we cannot validate. Review our Provider Directory Management administrative policy for details. Noncompliance with this administrative policy may result in your termination from our network(s).

Questions

If you have questions about your provider listing and would like assistance before submitting changes on the Provider Data Maintenance Tool , please contact the following Provider Services team(s), as appropriate:

  • Horizon Managed Care Network and/or Horizon PPO Network: 1-800-624-1110, weekdays, from 8 a.m. to 5 p.m., Eastern Time (ET)
  • Horizon NJ Health networks: 1-800-682-9091, weekdays, from 8 a.m. to 5 p.m., ET.
  • Behavioral health providers can also send an email to: BHNetworkRelations@HorizonBlue.com. Please include your name, NPI and county.

NaviNet® is a registered mark of NaviNet, Inc.

Published on: June 7, 2021, 07:09 a.m. ET
Last updated on: June 7, 2021, 15:44 p.m. ET