We strongly encourage all dentists and dental professionals to submit their claims and pre-determinations to us electronically. Electronic claim submissions ensure accurate and timely processing.
Attachments and radiographs are not necessary when you submit your claims electronically, although we reserve the right to request them if necessary. For more information on enrolling to submit your claims electronically, please contact Horizon Healthcare Dental Services’ Professional Relations Department at 1-800-4DENTAL or email us at horizon_dental@HorizonBlue.com.
For technical questions pertaining to submitting your claims electronically please contact the Horizon BCBSNJ EDI Services Help Desk toll-free at 1-888-EDI-9242.
Paper Claims Submissions
Always complete the claim forms completely and accurately. Pay close attention to required fields since that will help minimize processing delays. Claims are the most vital link between your office and Horizon Healthcare Dental Services. Please submit them in a timely manner. "Helpful Hints" are provided below for your reference.
We encourage the following for more efficient claims processing:
|Complete||The newest ADA claim forms or Horizon Healthcare claim forms.
Using computer-generated or typed data.
All necessary fields of the claim form.
|Verify||All data is within the designated field/box.
Subscriber’s ID number is correct.
Procedure code is valid CDT-4 or CDT-5.
Outdated claim forms.
- Claims must include the subscriber’s 12-digit identification number. Three-digit alpha prefixes should be removed for dental claim submissions.
- Ask for the patient’s ID card at each visit in order to have the most current enrollment information available. Always photocopy both sides of the ID card for your files.
- Use the subscriber’s and/or patient’s full name, avoiding nicknames or initials.
- Provide the patient’s date of birth.
- Complete the group number field on the claim form when it appears on the ID card. Please note that claims may be processed without that information.
- If the patient has any other insurance, record it on the claim form. If another carrier is primary and we receive incomplete information, it will delay payment to you.
- Claims must include the dentist’s information to ensure correct processing for payment. This includes name, Taxpayer Identification Number, address and zip code.
- For date fields, please include month, day and year. We have found that some claims contain only the month and day, which delays processing.
- Please do not circle or highlight information, as it may cover data and cause it to become illegible.
- Always use accurate six-digit CDT-4 or CDT-5 procedure codes for each service performed.
- Include tooth and/or surface for procedure codes that require that information.
- Clearly itemize your charges and date(s) of service.