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.

How to access the tool
– Sign in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu.
– Mouse over Referrals and Authorization.
– Select Utilization Management Requests.

How to appeal denied authorizations and request referrals (pre-determination)
– Sign in to NaviNet and select Horizon BCBSNJ from the My Health Plans menu.
– From the Workflows for this Plan section, mouse over References and Resources and select Provider References Materials.
– Mouse over Policies & Procedures and select Utilization Management.
– Select Utilization Management Request Tool.
– Scroll down and select Learn How to Use the Utilization Management Request Tool.