Provider Self-Service Tools
The information you need is available to you online, 24/7. Our Provider self-service tools help you get the most out of partnering with Horizon BCBSNJ.
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Reimbursement Policies & GuidelinesReimbursement Policies & Guidelines
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- Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) SuppliesContinuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) Supplies
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- Evaluation and Management Services with Osteopathic Manipulative TreatmentEvaluation and Management Services with Osteopathic Manipulative Treatment
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- Modifier 56Modifier 56
- Modifier 57Modifier 57
- Modifier 76Modifier 76
- Modifier 77Modifier 77
- Modifier 78Modifier 78
- Modifier SUModifier SU
- Multiple Procedure Payment Reduction (MPPR) for EndoscopiesMultiple Procedure Payment Reduction (MPPR) for Endoscopies
- Multiple Procedure ReductionsMultiple Procedure Reductions
- Mutually and Non-Mutually Exclusive NCCI Supplemental EditsMutually and Non-Mutually Exclusive NCCI Supplemental Edits
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- Outpatient Therapy Daily MaximumOutpatient Therapy Daily Maximum
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- Removal of Impacted Cerumen Requiring InstrumentationRemoval of Impacted Cerumen Requiring Instrumentation
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Utilization ManagementUtilization Management
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Services Requiring Prior AuthorizationServices Requiring Prior Authorization
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- Prior Authorization Procedure Search ToolPrior Authorization Procedure Search Tool
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ResourcesResources
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Manuals & User GuidesManuals & User Guides
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Online ToolsOnline Tools
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- Radiation Therapy Medical Necessity DeterminationRadiation Therapy Medical Necessity Determination
- Utilization Management Request ToolUtilization Management Request Tool
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