New Feature: Authorizations Added to our Member Eligibility and Benefits Cost Share Estimator!
Our Eligibility and Benefits Cost Share Estimator on NaviNet®is the fastest and easiest way to check medical and behavioral health claim-level member eligibility, benefits and estimated out-of-pocket costs. You no longer need to call Provider Services for this information. The tool allows you to check information for multiple members during each session.
What's new – Services requiring authorizations now included!
We continue to monitor transactions and incorporate your feedback. To further enhance your experience, we updated the tool to return member cost share results for services requiring authorization. It will also tell you if a service requires an authorization and where to submit the request.
As a reminder:
The tool provides you with information for your patients enrolled in our Commercial and Medicare Advantage (including Braven℠ Health) plans with a member ID number that includes “3HZN”.
To learn more about how to use the tool, attend one of our educational webinars. We can also host webinars/trainings to walk you through the tool. Please contact your Network Specialist to schedule a session.
The tool provides a unique reference number with each successful transaction and a summary of the member benefits cost share. The reference number is the same one that you would receive if you spoke with a Provider Services Representative and can be used for any other billing/claim-related questions.
Access the tool in a few easy steps
Access the Horizon BCBSNJ plan central page on NaviNet.
Select Eligibility and Benefits from the Workflows for this Plan Menu.
Click on Cost Share Estimator.
You can read more about our Eligibility and Benefits Cost Share Estimator.