When to use HorizonDocs
- You can begin exchanging documents for Post Service Medical Records with Horizon AFTER your Provider TIN has been configured by the Horizon Team. Be sure to contact a Network Specialist to have your Provider TIN configured.
- Please DO NOT send Post Service Medical documentation we have not specifically requested through HorizonDocs.
- You can ONLY use HorizonDocs when requested or when you receive a letter advising to submit medical records to support an appeal after receiving an adverse claim determination.
- It is critical that you continue to use existing channels/processes to submit time-sensitive documentation.
- You will receive notification as to when these documents can be exchanged via HorizonDocs portal.
HorizonDocs is a digital tool for professional providers that makes responding to our requests for documentation faster, easier and more convenient. HorizonDocs is accessed through NaviNet.
HorizonDocs is a web-based, centralized document repository that allows us to securely request documentation from you and allows you to securely send documents to us, all in one place.
To send requested medical documentation, in the category drop down, you will select the Post Service Medical Records.
If you receive an adverse claim determination, you can appeal using HorizonDocs. You would select the category for Post Service Appeals.
In addition to sending requested medical documentation and post service appeals, you can use HorizonDocs to send a variety of other types of requested documentation including:
- Lists of members who require screenings
- Results and Recognition Performance and Incentive reports
- HEDIS® chart requests
- Electronic Health Records (EHR) Data Submission Templates
Benefits of HorizonDocs
HorizonDocs makes exchanging protected health information safe and secure. It also offers additional benefits and features, including
- The organization of documents by category and sub-category.
- Documents sent and received are based on your Tax ID Number.
- You control who can receive and send documentation via HorizonDocs based on the sensitivity level of the documents. Each user is assigned a permission level to view and respond to requests for Sensitive – Clinical documents, Sensitive – Non-clinical documents or General Documents.
- Email notifications are generated when documents are requested, sent and received.
NaviNet Security Officers and HorizonDocs
You can only access HorizonDocs by a link on NaviNet. All providers MUST have access to NaviNet to use HorizonDocs.
Providers who do not have access to NaviNet can register online.
- To register, submit the requested contact and office information and follow the registration process.
- The user who registers the provider on NaviNet will automatically be assigned as the Security Officer for the provider.
Before you can use HorizonDocs, your office's Security Officer has to establish settings and grant access for users in your office. Your Security Officer is responsible for:
- Setting up and managing user permissions in your office so that documents can be viewed by the appropriate staff per roles and “sensitivity level” settings.
- Registering users' email addresses so they receive email notices when we request information through HorizonDocs.
How to access HorizonDocs
Once your Security Officer grants you access, you can:
- Sign in to NaviNet.
- Select Horizon BCBSNJ or Horizon NJ Health from the My Health Plans menu.
- Click HorizonDocs within the Workflows for this Plan section.
If the HorizonDocs option is not available, try these two steps.
- Click on Horizon Email Share and review the information. If correct, hit accept; if wrong, update and hit accept.
- Sign out of NaviNet and sign back in.
- If the option is still not there, your Security Officer must provide you access.
NaviNet should only be contacted for Security Officer issues.
For technical issues related to the HorizonDocs tool after you are signed into NaviNet, please contact the Horizon Helpdesk by emailing Provider_Portal@HorizonBlue.com or calling 1-888-777-5075, option 3.
If you have questions about HorizonDocs, please contact your Network Specialist, Hospital Network Specialist or Ancillary Reimbursement Analyst.