Provider Self-Service Tools
The information you need is available to you online. Our self-service tools help you get the most out of working with us. Access our self-service tool guide for more information.
Keep in mind that using these tools will be important because as of November 1, 2023, Provider Services representatives will no longer assist with the following inquiries:
- Member eligibility and enrollment
- Claims and payment status
- Expected patient costs (preservice)
- Updating your information in Horizon’s systems
- Credentialing online (coming soon)
Drug Authorizations Tool
Submit drug prior authorizations (PAs) for medications covered through Horizon pharmacy benefits.
Eligibility and Benefits Cost Share Estimator
Our Eligibility and Benefits Cost Share Estimator gives you access to medical and behavioral health claim-level member eligibility, benefits and out-of-pocket costs.
Interactive Voice Response System (IVR)
The Interactive Voice Response (IVR) system for our physicians and other health care professionals make it easy for you to do business with us over the phone, 24 hours a day, seven days a week, generally including weekends and holidays.
NaviNet
Visit NaviNet – your online go-to resource. Learn more about what you will find on the Horizon BCBSNJ plan page.
Prior Authorization Procedure Search Tool
Find out if services require prior authorization for your Horizon patients.
Provider Data Maintenance Tool
Quickly and conveniently make changes to the information we display on the Doctor & Hospital Finder.
Utilization Management Request Tool
Submit authorization and referral (pre-determination) requests and verify the status of previously submitted authorization or referral (pre-determination) requests easily and securely through our Utilization Management Request Tool.
Additional resources
You can reference the following additional sources for support:
- Online drug authorization tool - Streamline your drug preapproval process. Use Navinet.net to quickly send your drug prior authorizations to us and we will fax the authorization response to your office.
- Search MedWatch - Access the FDA Safety Information and Adverse Event Reporting Program
- E-Prescribe - Including two technology enablement programs, eRx NOW™ and iScribe as well as incentive programs
- Specialty Pharmaceutical Programs - Conveniently obtain certain medications for members