HorizonDocs 2023 Training
Today we will be reviewing step-by-step instructions on how to utilize the HorizonDocs tool that can be accessed on NaviNet to submit Post Service Medical Records and Post Service Appeals to Horizon Blue Cross and Blue Shield of New Jersey and Horizon NJ Health.
Note: Over the course of this training, “Horizon” refers to both Horizon Blue Cross Blue Shield of New Jersey and Horizon NJ Health.
What is HorizonDocs?
HorizonDocs is a web-based centralized document repository that allows Horizon to securely exchange documents with Providers. The use of HorizonDocs is an option to replace mailing or faxing medical records to us.
HorizonDocs is easy, fast, and secure. It also provides proof of submission. The tool will give providers a better document exchange experience. It will eventually replace all other modes of exchanging documents including secure blue emails, fax and MFT.
Key Features
- Web-based tool, accessible via NaviNet Provider Portals (Horizon BCBSNJ and Horizon NJ Health)
- Documents organized by Category and Sub-Category (e.g. Post Service Medical Records and Post Service Appeals: Commercial, SHBP, FEP, Braven and ITS Host)
- Email notification to designated users when Horizon sends document
- Documents sent to Providers based on TIN
- Users are assigned permission to view documents based on sensitivity level of a document
- Sensitive - Clinical
- Sensitive - Non Clinical
- General
- Providers assign their users permissions based on the type of documents they should be able to view
How to Use HorizonDocs to Submit Post Service Medical Records
In order to access Horizon Docs, you must be registered with NaviNet. Your department Security Officer will set up user permissions for each staff member. Once access is granted, users can access Horizon Docs, view, download and send documents with Horizon. If you are currently using NaviNet, you can skip Step 1.
For Post Service reviews:
- Select the category: Post Service Medical Records.
- It's important to select the correct sub-category based on the member's coverage. The options available are: Commercial, SHBP, FEP, Braven and ITS Host.
For Post Service Appeals
- Providers now have the option to submit medical records to support an appeal after receiving an adverse claim determination.
- The category that should be selected is “Post Service Appeals”.
- For the sub category, it's important to select the correct sub category based on the member's coverage. The options available are “Commercial, SHBP, FEP, Braven and ITS Host”.
Step 1: Register for access to NaviNet
HorizonDocs can only be accessed by a link on NaviNet. All providers MUST have access to NaviNet to access HorizonDocs.
- Providers who do not have access to NaviNet can register at www.navinet.net
- Provide 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
- Security Officer is a special role that will be responsible for:
- Setting up and managing permissions for their users to view documents based on “Sensitivity Level.”
- Registering email addresses of users in their office who should be notified when Horizon sends a new document belonging to a specified Sensitivity Level.
Step 2: Provider Security Officer sets up user permissions based on document Sensitivity Level.
The security officer is responsible for assigning users with their security levels.
Users must have at least one sensitivity level, but they can have all three.
Sensitivity levels are based on the types of documents to which the individual will have access.
Sensitivity Levels
- Security Officers must assign each user at least one of the following sensitivity levels:
- Sensitive – Clinical: may contain PHI/PII, but no financial data
- Sensitive – Non-Clinical: may contain PHI/PII and financial data, but no clinical data
- General: contains only non-PHI, non-PII , non-financial data
- All documents on HorizonDocs will be associated with one of the above sensitivity levels.
- Users will only be able to see documents that are associated with sensitivity levels they have been assigned.
- Security Officer may assign each user multiple sensitivity levels. For example: if a user is authorized to see all documents sent by Horizon, they must be assigned all three sensitivity levels.
- There are two separate NaviNet Provider Portals that can be accessed at (www.navinet.net):
- Horizon NJ Health Plan Central
- Horizon BCBSNJ Plan Central
- The Security Officer must set sensitivity levels for users on the Plan Central page from which they access HorizonDocs. For example: If a user accesses HorizonDocs via the Horizon BCBSNJ Plan Central page, their sensitivity level must be set on the Horizon BCBSNJ Provider Portal.
- If a user will access HorizonDocs via both Horizon NJ Health and Horizon BCBSNJ, the Security Officer must set user sensitivity levels separately on each Provider Portal. For example: If a user accesses HorizonDocs using the same TIN from both the commercial and GP portals, the security officer should set up the same permissions on both the Commercial and GP portal. This is so the user has the same experience on HorizonDocs irrespective of which portal the user logs in from.
Set Up User Permissions
This image shows an image of how you would access NaviNet Administration, one of the options located on the top ribbon on NaviNet home page.
- Click on the Down arrow next to the Administration line and click on Manage User Permissions.
- Your next screen will be where you give permission to the individuals in your office that will be utilizing the tool. The process is very easy and self-explanatory.
- On the User Search screen, select the user whose permissions you would like to change, and click Edit Access.
- Repeat for all users who need to access HorizonDocs
- Security Officer can change user permissions at any time
- On the User Transaction Management screen, you will see a listing of items that for which you want to grant permission.
Reminder: the security officer MUST assign themselves permission as well. We do recommend that Security Office assigns themselves all three sensitivity levels. That will ensure that at least one person receives all documents sent by Horizon.
Please use the NaviNet support videos and FAQs to provide you with assistance if needed.
Security Officers have their own tab full of useful information, so please take advantage of it.
Additional Resources
Please feel free to use these links to access additional information to set up user permissions:
NaviNet Security Officers: Manage Transaction Access
Step 3: Provider Security Officer registers email addresses for notification when Horizon sends documents.
Security Officer: Register email addresses
Now we will go through the process steps for the Provider Security Officer to register email addresses for notification when Horizon sends documents.
In the previous screenshots we went over how to give permission to individuals to the tool on NaviNet. Now we cover how to give users sensitivity level access. Hopefully, you are familiar with how to access the health plan. If not, here are the steps for you:
- Access HorizonDocs on the NaviNet toolbar, select Health Plans and then click Horizon NJ Health or Horizon BCBSNJ.
- Security Officer can access HorizonDocs only AFTER they set up permission for themselves.
- After assigning their own permission, Security Officer must log out and log back into NaviNet Provider Portal to see HorizonDocs link.
- Once in the Plan Central Page, regardless if Commercial or Government Programs, the HorizonDocs link will be under the Workflows for this Plan section.
- The link will not be accessible if the user was not given permission by the security officer.
- If they were and it is not visible, use the Horizon Email Share. View the information and make any necessary updates. Close out of NaviNet and go back in.
- If that does not work, the security officer granted permission to the tool and you did the email share, please contact NaviNet directly for assistance.
Here are the steps for a security officer to add email addresses of users in your office to be notified when we send out documents:
- Once a Security Officer logs in, a message box will display prompting the Security Officer to register email addresses of users in their office who should be notified when Horizon sends a new document.
- Click Yes to register email addresses
- Click No to skip this step and view documents
- The message box will only be displayed for Security officers.
- The message box will continue to display each time a Security Officer logs on to HorizonDocs, until at least one email address has been entered for each TIN/Sensitivity Level combination for that provider.
In this image, we see that the Security Officer option is active. Here you will provide the email address and the sensitivity for each of the users.- To register email addresses, select a TIN and Sensitivity combination from the drop down menus.
- Enter one or more email addresses that will receive notification when Horizon sends a document to that TIN/Sensitivity.
- Click Save.
- This slide is a reminder that you can access this page at any time by simply clicking on the Security Officer Tab option at the top of the screen. Only security officers have access to this information and can edit information.
User: Exchange Documents with Horizon
Now we will continue to review all the features/fields in the HZN Docs application. Next, we will view the screens you see. You will review each field (review each item in detail listed on the right of the slide):
- TIN: Provider TIN sending the document (i.e., your TIN)
- Category: Document category assigned by provider
- Sub-Category: Document Sub-Category assigned by provider
- File Name: Name of the document sent
- Sent By: Username of the provider who sent the document
- Sent Date: Date when document was sent
- Action: Clicking the blue arrow icon allows you to download the document to your desktop
- The search bar at the top of the page can be used to search for or filter documents by:
- TIN
- Category
- Sub-Category
- Enter date range when document was sent using the Sent From Date and Sent To Date fields
- Click Search button
- Documents matching your search criteria will be displayed on the page
- To clear search criteria and reset the page, click the reset button
Additional fields on the screen you, the provider can view. This will enable you to search for documents by your TIN, category, sub category and date.
Search for Documents sent by Provider
- Search bar at the top of the page can be used to search for or filter documents by
- Select one or more Search Criteria
- TIN
- Category
- Sub Category
- Date Range when document was sent using the Sent From Date and Sent To Date fields
- Click Search button
- Documents matching your search criteria are displayed on the page
- To clear Search Criteria and reset the page, click the reset button.
- Select one or more Search Criteria
- 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 documentation through HorizonDocs that 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
Now we will walk through the process steps to upload a document to send to Horizon:
- Enter your Name
- Select the Provider TIN from the drop down list.
- Select the Category of the document from the dropdown list. Post Service Medical Records or Post Service - Appeals.
- You can only select the categories you are assigned access to.
- Contact your Security Officer for access to other categories.
- Review the Quick Reference Guide slide to determine the best category to use.
- Select the Sub-Category from the drop down list.
- Only Sub Categories belonging to the selected Category will be displayed
- Enter your Email Address
- Optional but recommended:
- Enter the Horizon contact email
- Enter the Horizon contact name
- Enter any Comments
- Browse to select the document(s) you want to upload.
- You can upload up to 10 documents in one transaction.
- Each document in a transaction must have the same Category and Sub-Category.
Click Next after entering all required information on the Upload Documents page. This button will only be enabled when all required fields are completed
A Confirmation Page is displayed. See below screenshot.
- The Confirmation page shows all the information provided on the Upload Document page for you to review.
- Review the Confirmation Page. If you need to make any changes, click the Back button, and make the edit(s).
If there are no changes, click Confirm.
A Confirm Upload dialog box is displayed.
- If you are ready to upload the document click Yes to send the documents to Horizon.
- If you are not ready to send the documents click No. This will take you back to the Upload Document page.
How to identify validation that the document was successfully sent to Horizon:
- While the document is being uploaded, the progress of the upload will be displayed as an alert (bell icon).
- Click the bell icon to hide the window
- A pop-up window with a green check mark will be displayed.
- If the document was not successfully uploaded, a red “X” will be displayed in the pop up window.
- If the document is successfully uploaded, it will appear at the top of the Provider to Horizon page.
- If the document was not successfully sent to Horizon, it will not appear on the Provider to Horizon Page.
IF you are having issues viewing the pop-up windows, please make sure that your pop-up blocker is disabled for this site.
Quick Reference Guide
Provider to Horizon
Before sending a Document to Horizon, please review the attached spreadsheet for:
- Categories for Documents sent by Providers
- Sub-Categories associated with Categories
- Description of the types of documents that should be assigned to each Category/Sub-Category
- Sensitivity Level associated with the Category
- Note: New Category Post Service Appeals will be available
Additional categories:
Reminders
You can begin exchanging Post Service Medical documents with Horizon AFTER your Provider TIN has been configured by the Horizon Team. Be sure to contact a Network Specialist to have your TIN configured.
If you don't see HorizonDocs. click on Horizon Email Share under the Workflows for this Plan section. Input your email and hit accept.
Log out and log back in to see if the tab is now available.
If HorizonDocs is still not available follow the Security Officer instructions on prior slides.
Troubleshooting Issues
Knowing who and where to call when you come across and issue can be confusing so hopefully the information provided here will help with the decision-making.
It's important to know that HorizonDocs is a Horizon tool that is only housed on NaviNet, therefore the only time you would reach out to NaviNet is if you are having a Security Officer issue.
Any technical issue, meaning that you signed into NaviNet and gotten into the HorizonDocs tool but are having some technical issue like you are not receiving the confirmation email when you have successfully submitted documents, you would reach out to Horizon Helpdesk…..
By either sending an email to Provider_Portal@horizonblue.com or calling 888-777-5075 and choosing option 3.
Either way you will need to provider group name, tax id number, contact information, NaviNet username, and a description of what is or is not occurring.
