Medical Policy Criteria and Guidelines

TurningPoint will manage and maintain the medical policy criteria and guidelines that will be used to conduct PA/MND reviews as part of this program. The medical policy criteria and guidelines will be effective November 1, 2018 and will only apply to those Horizon BCBSNJ fully insured members included within the scope of this program.

• You may obtain copies of the medical policy criteria and guidelines by calling TurningPoint at 1-833-436-4083, Monday through Friday between 8 a.m. and 5 p.m., Eastern Time (ET).
   
• Beginning October 22, 2018, access to the medical policy criteria and guidelines will be available via NaviNet®.

Practices that do not have access to NaviNet may request access to TurningPoint’s web portal by calling TurningPoint at 1-833-436-4083, Monday through Friday between 8 a.m. and 5 p.m., ET to register to obtain access credentials.

CPT® is a registered trademark of the American Medical Association.

NaviNet® is a registered trademark of NaviNet, Inc.

TurningPoint Healthcare Solutions, LLC supports Horizon Blue Cross Blue Shield of New Jersey in the administration and utilization management review of certain orthopedic surgical services for coverage. TurningPoint Healthcare Solutions, LLC is independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association.