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Process Change: Precertification/Prior Authorization for Post-Acute Facility Requests Submissions

Effective April 1, 2019, Horizon BCBSNJ will no longer accept precertification/prior authorization of initial intake requests for Post-Acute Facility care by fax.

Beginning April 1, 2019, requests for precertification/prior authorization for Post-Acute care must be submitted either:

  • Through our online Utilization Management Request Tool or
  • By calling 1-844-243-3450, prompt 2, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time.

SUBMITTING PRECERTIFICATION/PRIOR AUTHORIZATION REQUESTS ONLINE
Please begin submitting requests online now to help ensure preparation for the April 1, 2019 deadline.

Registered NaviNet® users may submit authorization requests online. Sign in to NaviNet.net, and from the My Health Plans menu:

  • Select Horizon BCBSNJ.
  • Mouse over Referrals and Authorization.
  • Click Utilization Management Requests.

To access information about using our Utilization Management Request Tool, sign in to NaviNet.net, and from the My Health Plans menu:

  • Select Horizon BCBSNJ.
  • Mouse over References and Resources and click Provider Reference Materials.
  • Mouse over Policies & Procedures and click Utilization Management.
  • Click Utilization Management Request Tool.

NOT REGISTERED FOR NAVINET?
Access to NaviNet is free. To register, visit NaviNet.net and click Sign Up.

If you are not able to submit requests for precertification/prior authorization through our online Utilization Management Request Tool on NaviNet.net, call our Post-Acute Facility team at 1-844-243-3450, prompt 2.

Requests for precertification/prior authorization will not be accepted through the following fax numbers on and after April 1, 2019:

  • 1-973-274-2367 Prior Authorization for Post-Acute Facility Intake Requests
  • 1-973-274-4022 Prior Authorization for Post-Acute Facility Additional Information

NaviNet® is a registered trademark of NaviNet, Inc.

Published on: December 21, 2018, 09:06 a.m. ET
Last updated on: December 21, 2018, 09:50 a.m. ET