COVID-19
Stay informed.Get the latest information on COVID-19.
Alert
Toggle menu
- BACKback to www.horizonblue.com
- PROVIDERS
-
COVID-19 InformationCOVID-19 Information
- COVID-19 Information
- Behavioral Health Continuity During the COVID-19 Public Health EmergencyBehavioral Health Continuity During the COVID-19 Public Health Emergency
- COVID-19 Frequently Asked QuestionsCOVID-19 Frequently Asked Questions
- Members Will Incur No Costs for Treatment of COVID-19Members Will Incur No Costs for Treatment of COVID-19
- Waiving Pre-Certification/Prior Authorization requirements for Physical Health Post-Acute Facility AdmissionsWaiving Pre-Certification/Prior Authorization requirements for Physical Health Post-Acute Facility Admissions
- Horizon BCBSNJ Commits $2.5 Million for Masks, Face Shields, Food and Social Services to Protect Our Communities and Our Health ProfessionalsHorizon BCBSNJ Commits $2.5 Million for Masks, Face Shields, Food and Social Services to Protect Our Communities and Our Health Professionals
- COVID-19 Update: Authorizations Waived for Oxygen Following ER DischargeCOVID-19 Update: Authorizations Waived for Oxygen Following ER Discharge
- Reminder to use specific codes when evaluating for COVID-19Reminder to use specific codes when evaluating for COVID-19
- COVID-19 Update: Telemedicine Reimbursement Policy AddendaCOVID-19 Update: Telemedicine Reimbursement Policy Addenda
- Provisionally Join Horizon BCBSNJ Network(s) to Assist with the COVID-19 PandemicProvisionally Join Horizon BCBSNJ Network(s) to Assist with the COVID-19 Pandemic
- Waiving Pre-Certification/Prior Authorization requirements for acute inpatient facility admissionsWaiving Pre-Certification/Prior Authorization requirements for acute inpatient facility admissions
- Providing Telephonic care with no costs to membersProviding Telephonic care with no costs to members
- COVID-19 Response: Eliminating Cost-Sharing for Qualified In-Network Telemedicine ServicesCOVID-19 Response: Eliminating Cost-Sharing for Qualified In-Network Telemedicine Services
- COVID-19 CPT testing codesCOVID-19 CPT testing codes
- Eliminating Cost Sharing Related to COVID-19 Testing and EvaluationEliminating Cost Sharing Related to COVID-19 Testing and Evaluation
- Staying Informed: COVID-19 CoronavirusStaying Informed: COVID-19 Coronavirus
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Why JoinWhy Join
- Why Join
- Our CommitmentOur Commitment
-
Join Our NetworksJoin Our Networks
- Join Our Networks
- Join a Horizon BCBSNJ or Horizon NJ Health Network (Physicians and Other Healthcare Professionals )Join a Horizon BCBSNJ or Horizon NJ Health Network (Physicians and Other Healthcare Professionals )
- Join the Horizon BCBSNJ Network (Ancillary Providers)Join the Horizon BCBSNJ Network (Ancillary Providers)
- Join the Horizon NJ Health Network (Ancillary Providers)Join the Horizon NJ Health Network (Ancillary Providers)
- Join the Horizon Dental NetworkJoin the Horizon Dental Network
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Our Healthcare FacilitiesOur Healthcare Facilities
- Vendor RelationshipsVendor Relationships
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Products & ProgramsProducts & Programs
- Products & Programs
-
AIM Specialty HealthAIM Specialty Health
- AIM Specialty Health
- Diagnostic Imaging ProgramDiagnostic Imaging Program
- Frequently Asked QuestionsFrequently Asked Questions
- Groups Enrolled With AIMGroups Enrolled With AIM
- Muskoskeletal ProgramMuskoskeletal Program
- Procedure Codes Reviewed by AIMProcedure Codes Reviewed by AIM
- Sleep Disorder Management ProgramSleep Disorder Management Program
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Case ManagementCase Management
- Chronic Care ProgramChronic Care Program
- Clinical Laboratory ServicesClinical Laboratory Services
-
BlueCard ProgramBlueCard Program
- BlueCard Program
- BlueCard AnnouncementsBlueCard Announcements
- BlueCard ClaimsBlueCard Claims
- BlueCard Medical Policy/Pre-Certification InfoBlueCard Medical Policy/Pre-Certification Info
- BlueCard Program FAQsBlueCard Program FAQs
- BlueCard Program OverviewBlueCard Program Overview
- BlueCard Program TutorialBlueCard Program Tutorial
- GeoBlue: International CoverageGeoBlue: International Coverage
- How to Identify BlueCard MembersHow to Identify BlueCard Members
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Dental ServicesDental Services
- EDI & EFT TransactionsEDI & EFT Transactions
-
eviCore Health CareeviCore Health Care
- eviCore Health Care
- ArchiveArchive
- Cardiology Imaging ProgramCardiology Imaging Program
- Molecular and Genomic Testing ProgramMolecular and Genomic Testing Program
- Musculoskeletal ProgramMusculoskeletal Program
- Radiation Therapy ProgramRadiation Therapy Program
- Radiology/Imaging ServicesRadiology/Imaging Services
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Horizon Behavioral Health℠Horizon Behavioral Health℠
- Horizon Care@HomeHorizon Care@Home
- Medical Injectables ProgramMedical Injectables Program
- navihealthnavihealth
- Patient Health SupportPatient Health Support
- Pharmacy ProgramsPharmacy Programs
-
ProductsProducts
- Products
- Medicare Advantage Network Plans OverviewMedicare Advantage Network Plans Overview
- Managed Care PlansManaged Care Plans
- PPO and Indemnity ProductsPPO and Indemnity Products
- OMNIA Health PlansOMNIA Health Plans
- Horizon Medicare Blue (PPO)Horizon Medicare Blue (PPO)
- Horizon Medicare Blue Advantage (HMO)Horizon Medicare Blue Advantage (HMO)
- NJ SHBP/SEHBP Benefit PlansNJ SHBP/SEHBP Benefit Plans
- FEPFEP
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Recognition Programs and PartnershipsRecognition Programs and Partnerships
- Risk Adjustment OverviewRisk Adjustment Overview
-
Self ServiceSelf Service
- Self Service
-
Interactive Voice Response System (IVR)Interactive Voice Response System (IVR)
- Interactive Voice Response System (IVR)
- Referral Process Using the Interactive Voice Response SystemReferral Process Using the Interactive Voice Response System
- Effective use of the Interactive Voice Response SystemEffective use of the Interactive Voice Response System
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Provider Online ServicesProvider Online Services
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Surgical and Implantable Device Management ProgramSurgical and Implantable Device Management Program
- Surgical and Implantable Device Management Program
- About the Surgical and Implantable Device Management ProgramAbout the Surgical and Implantable Device Management Program
- Cardiac ServicesCardiac Services
- Orthopedic ServicesOrthopedic Services
- Medical Policy Criteria and GuidelinesMedical Policy Criteria and Guidelines
- PA/MND ProcessPA/MND Process
- Using Out-of-Network Providers in Surgical ServicesUsing Out-of-Network Providers in Surgical Services
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Value-Based ProgramsValue-Based Programs
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Policies & ProceduresPolicies & Procedures
- Policies & Procedures
- HEDIS® ResourcesHEDIS® Resources
-
Claim Submission & BillingClaim Submission & Billing
- Claim Submission & Billing
- Claim Editing PoliciesClaim Editing Policies
- Claim SubmissionClaim Submission
- Electronic Claim AdjustmentsElectronic Claim Adjustments
- Explanation of PaymentExplanation of Payment
- PCP Billable ListsPCP Billable Lists
- Pre-payment Correct Coding ReviewsPre-payment Correct Coding Reviews
- Prompt Pay GuidelinesPrompt Pay Guidelines
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Demographic UpdatesDemographic Updates
- Demographic Updates
- The Importance of Demographic UpdatesThe Importance of Demographic Updates
- Provider Directory Management PolicyProvider Directory Management Policy
- CMS Audits to Validate Directory InformationCMS Audits to Validate Directory Information
- Updating Your Directory InformationUpdating Your Directory Information
- TIN Changes and Termination LettersTIN Changes and Termination Letters
- Nonparticipating Provider Demographic InformationNonparticipating Provider Demographic Information
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Inquiries, Complaints & AppealsInquiries, Complaints & Appeals
- Inquiries, Complaints & Appeals
- InquiriesInquiries
- ComplaintsComplaints
- Time Limits for Filing Inquiries/ComplaintsTime Limits for Filing Inquiries/Complaints
- Resolving Inquiries/ComplaintsResolving Inquiries/Complaints
- Appeals of Non-Utilization Management DeterminationsAppeals of Non-Utilization Management Determinations
- Appeals of Utilization Management/Medical Management DeterminationsAppeals of Utilization Management/Medical Management Determinations
- Appeals of Post Service Medical Necessity DeterminationsAppeals of Post Service Medical Necessity Determinations
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
PoliciesPolicies
- Policies
- Medical PoliciesMedical Policies
-
Administrative PoliciesAdministrative Policies
- Administrative Policies
- Allowable Practice Locations for PathologistsAllowable Practice Locations for Pathologists
- Appointment Availability Access Standards for Primary Care-Type Providers, ObGyns and SpecialistsAppointment Availability Access Standards for Primary Care-Type Providers, ObGyns and Specialists
- Behavioral Health Providers Access StandardsBehavioral Health Providers Access Standards
- Credentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) ProvidersCredentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) Providers
- Credentialing and Recredentialing Policy for Participating Physicians and Healthcare ProfessionalsCredentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals
- EDI and NaviNet Claims Submission RequirementEDI and NaviNet Claims Submission Requirement
- Electronic Funds Transfer (EFT)Electronic Funds Transfer (EFT)
- Material Adverse Change (MAC) Notification PolicyMaterial Adverse Change (MAC) Notification Policy
- Medical Records Documentation StandardsMedical Records Documentation Standards
- Medicare Advantage ReadmissionMedicare Advantage Readmission
- Never EventsNever Events
- Out-of-Network Referral PolicyOut-of-Network Referral Policy
- Physician and Healthcare Professional Counseling and Termination Policy - Professional CompetencyPhysician and Healthcare Professional Counseling and Termination Policy - Professional Competency
- Participation Status in Products that Utilize Tiering and/or Subset of an Existing Horizon NetworkParticipation Status in Products that Utilize Tiering and/or Subset of an Existing Horizon Network
- Practitioner Office Site Quality and Medical Record Keeping StandardsPractitioner Office Site Quality and Medical Record Keeping Standards
- Provider Directory ManagementProvider Directory Management
- Retainer Based MedicineRetainer Based Medicine
- Tier Awareness PolicyTier Awareness Policy
- Use of Horizon Hospital Network Performance DataUse of Horizon Hospital Network Performance Data
- Use of Practitioner Performance DataUse of Practitioner Performance Data
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- BlueCard Medical PoliciesBlueCard Medical Policies
-
Reimbursement Policies & GuidelinesReimbursement Policies & Guidelines
- Reimbursement Policies & Guidelines
- After-hours and Weekend CareAfter-hours and Weekend Care
- Ambulance ServicesAmbulance Services
- Ambulatory Electrocardiographic MonitoringAmbulatory Electrocardiographic Monitoring
- Anesthesia Reimbursement GuidelinesAnesthesia Reimbursement Guidelines
- ASC Multiple Procedure MethodologyASC Multiple Procedure Methodology
- Assistant at SurgeryAssistant at Surgery
- Balloon SinuplastyBalloon Sinuplasty
- Bariatric Surgery Billed With Hiatal Hernia RepairBariatric Surgery Billed With Hiatal Hernia Repair
- Bilateral ProceduresBilateral Procedures
- Billing Guidelines for Maternity ServicesBilling Guidelines for Maternity Services
- Cardiac Event DetectionCardiac Event Detection
- Cardiovascular Implant Device Monitoring ServicesCardiovascular Implant Device Monitoring Services
- Chemotherapy AdministrationChemotherapy Administration
- Chronic Care Management ServicesChronic Care Management Services
- Claim Editing PoliciesClaim Editing Policies
- Claims Requiring Additional DocumentationClaims Requiring Additional Documentation
- ClaimsXten Editing RulesClaimsXten Editing Rules
- Clinical Trials Support ProgramClinical Trials Support Program
- Co-Surgeon ReimbursementCo-Surgeon Reimbursement
- Colonoscopy with Modifier 59Colonoscopy with Modifier 59
- Conscious SedationConscious Sedation
- Consultation Services PaymentConsultation Services Payment
- Consumable Medical SuppliesConsumable Medical Supplies
- Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) SuppliesContinuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) Supplies
- Daily Management of Epidural or Subarachnoid Continuous Drug AdministrationDaily Management of Epidural or Subarachnoid Continuous Drug Administration
- Daily Maximum Units for Surgical Pathology and Microscopic ExaminationDaily Maximum Units for Surgical Pathology and Microscopic Examination
- Determination of Refractive StateDetermination of Refractive State
- Diabetic Screening ServicesDiabetic Screening Services
- Diabetic SuppliesDiabetic Supplies
- Distinct Procedural Service ModifiersDistinct Procedural Service Modifiers
- DME Rent to PurchaseDME Rent to Purchase
- Drug and Immunization PricingDrug and Immunization Pricing
- Duplex ScanningDuplex Scanning
- Drug Wastage – Modifier JWDrug Wastage – Modifier JW
- Duplicate Claim Logic for Independent Laboratory ServicesDuplicate Claim Logic for Independent Laboratory Services
- Enhancement to CMS Always Bundled EditEnhancement to CMS Always Bundled Edit
- Evaluation and Management Services with Chiropractic Manipulative TreatmentEvaluation and Management Services with Chiropractic Manipulative Treatment
- Evaluation and Management Services with Osteopathic Manipulative TreatmentEvaluation and Management Services with Osteopathic Manipulative Treatment
- Evaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo, Myocardial Profusion ImagingEvaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo, Myocardial Profusion Imaging
- Frequency of Care Coordination Services and ESRD ProceduresFrequency of Care Coordination Services and ESRD Procedures
- Frequency of G0179Frequency of G0179
- Hip ArthroscopyHip Arthroscopy
- Hot or Cold Pack TherapyHot or Cold Pack Therapy
- Inpatient ConsultationsInpatient Consultations
- Knee ArthroscopyKnee Arthroscopy
- Lab Panel RebundlingLab Panel Rebundling
- Laboratory Services Billed by PhysiciansLaboratory Services Billed by Physicians
- Maternity ReimbursementMaternity Reimbursement
- Microsurgery and Robotic SurgeryMicrosurgery and Robotic Surgery
- Modifier 25Modifier 25
- Modifier 50 Bilateral GuidelinesModifier 50 Bilateral Guidelines
- Modifier 52Modifier 52
- Modifier 53Modifier 53
- Modifier 54Modifier 54
- Modifier 55Modifier 55
- Modifier 56Modifier 56
- Modifier 57Modifier 57
- Modifier 76Modifier 76
- Modifier 77Modifier 77
- Modifier 78Modifier 78
- Modifier SUModifier SU
- Multiple Procedure ReductionsMultiple Procedure Reductions
- Mutually and Non-Mutually Exclusive NCCI Supplemental EditsMutually and Non-Mutually Exclusive NCCI Supplemental Edits
- Non-ESRD ESA Level ReportingNon-ESRD ESA Level Reporting
- Noncovered Related ServicesNoncovered Related Services
- Outpatient ConsultationsOutpatient Consultations
- Outpatient Laboratory Claims: Referring Practitioner RequiredOutpatient Laboratory Claims: Referring Practitioner Required
- Outpatient Therapy Daily MaximumOutpatient Therapy Daily Maximum
- Physician Extenders Non-Surgical ServicesPhysician Extenders Non-Surgical Services
- Pre-Admission TestingPre-Admission Testing
- Pulmonary Diagnostic Procedures when billed with E&M CodesPulmonary Diagnostic Procedures when billed with E&M Codes
- Radiology, Preliminary and Double ReadsRadiology, Preliminary and Double Reads
- RadiopharmaceuticalsRadiopharmaceuticals
- Reimbursement and Billing Guidelines for Anesthesia ClaimsReimbursement and Billing Guidelines for Anesthesia Claims
- Removal of Impacted Cerumen Requiring InstrumentationRemoval of Impacted Cerumen Requiring Instrumentation
- Screening and Diagnostic Mammography & 3D TomosynthesisScreening and Diagnostic Mammography & 3D Tomosynthesis
- Site of Service DifferentialSite of Service Differential
- Smoking CessationSmoking Cessation
- Status N CodesStatus N Codes
-
Telemedicine ServicesTelemedicine Services
- Telemedicine Services
- Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and productsTelemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and products
- Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon Medicare AdvantageTelemedicine Services Reimbursement Policy: Temporary Addendum for Horizon Medicare Advantage
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Ulcer Debridement and Ulcer StagesUlcer Debridement and Ulcer Stages
- Urinalysis with Evaluation and Management (E&M) ServicesUrinalysis with Evaluation and Management (E&M) Services
- Urine Drug Screening/TestingUrine Drug Screening/Testing
- Vitamin D TestingVitamin D Testing
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
Utilization ManagementUtilization Management
- Utilization Management
- Clinical Practice GuidelinesClinical Practice Guidelines
- PT/OT Outpatient Prior Authorization for Horizon Medicare Advantage PlansPT/OT Outpatient Prior Authorization for Horizon Medicare Advantage Plans
-
Services Requiring Prior AuthorizationServices Requiring Prior Authorization
- Services Requiring Prior Authorization
- Prior Authorization Procedure Search ToolPrior Authorization Procedure Search Tool
- BlueCard MembersBlueCard Members
- Medicare AdvantageMedicare Advantage
- OMNIA Health PlansOMNIA Health Plans
- SHBP/SEHBPSHBP/SEHBP
- Unite Here HealthUnite Here Health
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Utilization Management Request ToolUtilization Management Request Tool
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
ResourcesResources
- Resources
- Cultural CompetencyCultural Competency
- HealthSphereHealthSphere
-
Manuals & User GuidesManuals & User Guides
- Manuals & User Guides
- AgreementsAgreements
- Ancillary ManualAncillary Manual
- Benefits-at-a-GlanceBenefits-at-a-Glance
- Hospital ManualHospital Manual
-
Participating Physician and Other Health Care Professional Office ManualParticipating Physician and Other Health Care Professional Office Manual
- Participating Physician and Other Health Care Professional Office Manual
- At Your ServiceAt Your Service
- The BlueCard ProgramThe BlueCard Program
- Claims Submissions and ReimbursementClaims Submissions and Reimbursement
- Coordination of BenefitsCoordination of Benefits
- HIPAAHIPAA
- Horizon Behavioral HealthHorizon Behavioral Health
- Horizon Hospital NetworkHorizon Hospital Network
- IdentificationIdentification
- Inquiries, Complaints and AppealsInquiries, Complaints and Appeals
- Member Rights and ResponsibilitiesMember Rights and Responsibilities
- Patient-Centered ProgramsPatient-Centered Programs
- Patient Health SupportPatient Health Support
- Payment Summaries and VouchersPayment Summaries and Vouchers
- Policies, Procedures and General GuidelinesPolicies, Procedures and General Guidelines
- ProductsProducts
- Provider ResponsibilitiesProvider Responsibilities
- Quality ManagementQuality Management
- Quality Recognition ProgramsQuality Recognition Programs
- ReferralsReferrals
- ServiceService
- Special ProgramsSpecial Programs
- Utilization ManagementUtilization Management
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Welcome Kit HandbookWelcome Kit Handbook
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Network SpecialistsNetwork Specialists
- NewslettersNewsletters
- Office Manager SeminarsOffice Manager Seminars
- Provider Self-Service ToolsProvider Self-Service Tools
-
TrainingTraining
- Training
- CMS Training RequirementsCMS Training Requirements
-
EducationEducation
- Education
- ProductsProducts
- NavinetNavinet
-
Online ToolsOnline Tools
- Online Tools
- Electronic Funds TransferElectronic Funds Transfer
- Health Risk AssessmentHealth Risk Assessment
- Radiation Therapy Medical Necessity DeterminationRadiation Therapy Medical Necessity Determination
- Utilization Management Request ToolUtilization Management Request Tool
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- WebinarsWebinars
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
-
FormsForms
- Forms
- Forms by Plan TypeForms by Plan Type
- Forms by Specialty TypeForms by Specialty Type
-
Forms by TypeForms by Type
- Forms by Type
- Appeal / DisputeAppeal / Dispute
- Assess / Evaluate / ExamineAssess / Evaluate / Examine
- AuthorizationsAuthorizations
- ClaimClaim
- ConsentConsent
- CredentialingCredentialing
- Electronic Transaction FormsElectronic Transaction Forms
- Enroll / Elect / ApplyEnroll / Elect / Apply
- Horizon NJ TotalCare (HMO D-SNP) FormsHorizon NJ TotalCare (HMO D-SNP) Forms
- Inquiry / RequestInquiry / Request
- Prescription Drug Mail OrderPrescription Drug Mail Order
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- Frequently Used FormsFrequently Used Forms
- MiscellaneousMiscellaneous
- W9 Form-DentalW9 Form-Dental
- W9 Form-MedicalW9 Form-Medical
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
- NewsNews
- FIND A DOCTOR
- MEMBER SIGN IN
- SHOP FOR A PLAN
