Access Our FAQs
When you have questions, access our FAQs on NaviNet®. There, you can quickly find information regarding these topics and more:
- Claims and payments
- Provider resources
- Eligibility and benefits
- Referrals and authorizations
- Office and provider management
To get started, log on to NaviNet.net, select Help and then select Horizon BCBSNJ.
Electronic Funds Transfer (EFT) is a fast and easy way to receive reimbursement from Horizon Blue Cross Blue Shield of New Jersey in an electronic format. Reimbursement for services are automatically deposited into the account(s) of your choice, eliminating the need to track and deposit paper checks.
Yes. Horizon BCBSNJ requires that all participating physicians, other health care professionals, ancillary providers and facilities must be registered for EFT.
The benefits of using EFT include:
- Quicker reimbursement into one or more designated bank accounts.
- Improved cash flow by eliminating mail time and check float.
- Elimination of bank fees for check deposits.
- Reduction in paperwork and overall administrative costs.
- Reduction in the opportunity for error or theft.
- Elimination of paper checks to track and deposit.
Q. Will Horizon BCBSNJ use EFT to withdraw money from my account for any claim payment recoveries or to satisfy any accounts receivables (ARs)?
EFT will only be used by us to make deposits into your designated accounts. Horizon BCBSNJ will not withdraw any amounts from these designated accounts.
EFT registration for physicians, other healthcare professionals and ancillary professional providers is performed through NaviNet. To register for Horizon BCBSNJ’s EFT, log in to www.NaviNet.net, and:
- Select Horizon BCBSNJ within the Plan Central dropdown menu
- Click Claim Management.
- Click EFT Registration.
EFT registration for ancillary facilities does not go through NaviNet. To initiate the EFT enrollment process, please complete a copy of our EFT Application for Ancillary Facilities form and mail it, along with a voided check to:
Horizon Blue Cross Blue Shield of New Jersey
3 Penn Plaza East – PP14K
Newark, NJ 07105-2200
Attn: Ancillary Reimbursement – EFT Enrollment
The EFT Registration link is only visible to those NaviNet users designated as “Security Officers”. If you do not have Security Officer rights, you will not see the EFT Registration link. Please call NaviNet Customer Care at 1-888-482-8057 for assistance.
Physicians, other healthcare professionals and ancillary professional providers that need help with EFT registration, may contact Horizon BCBSNJ’s e-Service Desk: call 1-888-777-5075, or e-mail provider_portal@HorizonBlue.com.
Upon initial enrollment, you will receive an on-screen confirmation number. In addition, the administrator (the person whose e-mail address was selected during registration) will receive an e-mail alert about the EFT registration.
To ensure the accuracy of routing from Horizon BCBSNJ to your practice’s bank account, we will make two test deposits (penny deposits) into the bank account on file. The person selected as the administrator on the account will receive an e-mail notification when the test deposits are available. When notified, the administrator must sign on and confirm the deposits.
EFT registration is not successful until the administrator signs on and confirms the test deposits.
In addition to making your EOPs available online, we will continue to mail paper statements for the first 30 days you receive EFT. After 30 days, your EOPs will be available online only.
If you need to print an EOP for any reason, simply sign on to NaviNet, select Horizon BCBSNJ from Plan Central and:
- Click Claim Management.
- Click Payment Status Inquiry.
- Search for and locate the payment in question.
- Click the View EOP icon.
- Click the PDF icon to view the EOP as a PDF and click File, then Print.
All claims processed for services provided to members enrolled in Horizon BCBSNJ plans are made via Electronic Funds Transfer (EFT) for providers receiving EFT. However, we do print and mail paper Explanations of Payments (EOPs) to accompany certain EFT payments made for services provided to members enrolled in the Federal Employee Program (FEP) and certain national account employer groups.
When selecting a Tax ID after your banking information in entered, ensure that you select Submit All Locations to include all suffixes associated with your Tax ID.
Physicians, other healthcare professionals and ancillary professional providers whose banking arrangements change, may simply sign on to NaviNet, go to the EFT Registration transaction and update the banking information online. After the update, a new set of test deposits will be conducted. Once the administrator confirms the test deposits, the EFT routing will change to the new bank account.
Ancillary facilities may submit changes to their bank account information, in writing, to their Ancillary Reimbursement Analyst. Please be sure to direct any such changes at least 30 days in advance to ensure there will be no interruption in your service.
Yes, Horizon BCBSNJ offers the Health Insurance Portability and Accountability Act (HIPAA) 835 Health Care Claim Payment/Advice transaction. The 835 transaction is an electronic remittance advice (ERA), to vendors such as LabCorp and clearinghouses such as Emdeon, Practice Insight, Gaffey + Associates, and others.
In turn, these clearinghouses make HIPAA 835 transaction services and training available to physician practices. Most physician offices and group practices do not have the translator required to receive electronic communications directly. Notification of availability of the ERA file will come from your software vendor, not Horizon BCBSNJ.
Yes, Horizon BCBSNJ offers a claim payment posting system called 835 postings. As with ERAs, you must have a translator in place for electronic communication. Your software vendor or Practice Management System (PMS) will likely offer the 835 package and will provide training on how to use the software and the posting reconciliation process.