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Cardiology Imaging Program

Horizon Blue Cross Blue Shield of New Jersey has partnered with eviCore healthcare to administer our Cardiology Imaging program by using evidence-based criteria and ensuring requests for advanced cardiac imaging meet quality standards recommended by organizations such as the American College of Cardiology, the American Heart Association and the Heart Rhythm Society and identifying the most appropriate cardiac imaging study based on the patient’s medical and prior imaging history.

Please note that eligibility and participation may vary based on line of business therefore, all providers should check eligibility and benefits prior to performing any services related to this program. In addition, actual benefit determinations cannot be made until a claim is received and is subject to the provisions of the patient’s present contract including any applicable deductible, coinsurance and/or coordination of benefits. Payment is dependent on the patient being an eligible Horizon BCBSNJ member at the time the services are rendered. Authorizations will be affected should the claim submitted differ from the information provided at the time of a request.



eviCore healthcare also manages Cardiology Imaging services provided to members enrolled in Horizon NJ Health plans and programs (including Medicaid Managed Care, NJ FamilyCare, Horizon NJ TotalCare (HMO D-SNP) and Managed Long Term Services & Supports (MLTSS). Visit the Horizon NJ Health eviCore healthcare webpage for information.

eviCore healthcare is an independent company that supports Horizon Blue Cross Blue Shield of New Jersey in the provision of Prior Authorization and/or Medical Necessity Review (PA/MND) of certain nonemergency radiology services.