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Quarterly Claim Editing Update: 4th Quarter 2018

On or about November 18, 2018, Horizon Blue Cross Blue Shield of New Jersey will implement an update to our claim editing rules and processes.

We encourage you to review details of this update in our Quarterly Claim Editing Update Report.

  • The changes noted in this report will be implemented on or about November 18, 2018.

    The effective date of the changes noted in this report will be November 1, 2018 (unless otherwise specified in the report). Changes noted in this report will apply to all claims finalized on and after the date of our implementation.¹

Read more about our Claim Editing Policies.

If you have questions, call a Physician Services representative at 1-800-624-1110 or an Institutional Services representative at 1-888-666-2535, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time.

¹ Claims that are finalized before the update is implemented will not be adjusted for the sole purpose of the claim editing update. Claims finalized before the update is implemented that are adjusted for other reasons after our systemic implementation will be processed based on the guidelines included in this quarterly update.

Clear Claim Connection™

Participating physicians, other health care professionals and facilities can review how updated claim editing rules impact reimbursement for certain code combinations by using the Clear Claim Connection available via NaviNet®.

To access Clear Claim Connection, log in to and:

  • Select Horizon BCBSNJ from the My Health Plans menu.
  • Mouse over Claim Management.
  • Click Clear Claim Connection.

NaviNet® is a registered trademark of NaviNet, Inc.

Published on: October 1, 2018, 16:12 p.m. ET
Last updated on: October 1, 2018, 16:23 p.m. ET