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Physical and Occupational Therapy Authorizations

As of August 24, 2018, prior authorization requests for PT/OT services must be submitted via our online Utilization Management Request Tool.

Our online Utilization Management Request Tool is accessible on NaviNet®. Sign in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu, then:

  • Mouse over Referrals and Authorizations
  • Select Utilization Management Requests

Providers will no longer have access to our online Physical and Occupational Therapy Authorization Tool.

The online Utilization Management Request Tool is for the use of rendering physical therapy and occupational therapy (PT/OT) providers to initiate requests for prior authorization. This tool cannot be used to create referrals for PT/OT services.

Claims processing and reimbursement for services provided are subject to member eligibility and all member and group benefits, limitations and exclusions.