New Jersey's phased approach to administer COVID-19 vaccines to those who live, work or study in the state is now underway. In the fight against coronavirus (COVID-19), we’re covering more of your patients’ costs and making their access to doctors and nurses easier. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. Latest Covid Surge Means Doubling Down on Jersey Strong. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Find my BCBS company . Horizon Healthcare Services Inc., Horizon Healthcare of New Jersey, Inc. (Commercial), Braven Health℠ and Horizon NJ Health (HNJH), hereinafter collectively "Horizon BCBSNJ" will comply with all accreditation requirements, applicable laws, regulations and other communications from Federal and State regulatory bodies and accrediting agencies as described in the “Reference” Section of this policy. Commercial HMO & POS, COVID-19 vaccines available in Essex County – Information for your staff and patients, Reimbursement Policy effective January 1, 2021: Add-on Payment for COVID-19 Diagnostic Testing Run on High Throughput Technology (U0005), Update: Members’ cost sharing waived for treatment of COVID-19 through March 2021, COVID-19 vaccines will be covered at 100%, Waiving Prior Authorization Requirements for Emergent In-Network Inpatient Admissions and Post-Acute Facility Admissions, Update: Cost-share waiver for telemedicine and COVID-19 testing extended, Cost Sharing on Claims with Multiple Diagnoses, Dates for Certain Prior Authorization Waivers Further Extended, Dates for Prior Authorization Waivers Extended, New Laboratory COVID-19 Antibody Testing Codes: 86328 and 86769, COVID-19 Update: Medical Policy Revisions & Implementations, 72 Doctors, Nurses, Pharmacists and Health Clinicians from Horizon BCBSNJ Answer Governor Murphy’s “HealthCare Professionals Call to Serve”, New Jersey Pandemic Relief Fund Efforts Get $2 Million Boost from Horizon, A special message from Howard A. Cutler, Vice President, Healthcare Delivery, Behavioral Health Continuity During the COVID-19 Public Health Emergency, Waiving Pre-Certification/Prior Authorization requirements for Physical Health Post-Acute Facility Admissions, Horizon BCBSNJ Commits $2.5 Million for Masks, Face Shields, Food and Social Services to Protect Our Communities and Our Health Professionals, COVID-19 Update: Authorizations Waived for Oxygen Following ER Discharge, Reminder to use specific codes when evaluating for COVID-19, COVID-19 Update: Telemedicine Reimbursement Policy Addenda, Provisionally Join Horizon BCBSNJ Network(s) to Assist with the COVID-19 Pandemic, Waiving Pre-Certification/Prior Authorization requirements for acute inpatient facility admissions, Providing Telephonic care with no costs to members, COVID-19 Response: Eliminating Cost-Sharing for Qualified In-Network Telemedicine Services, Eliminating Cost Sharing Related to COVID-19 Testing and Evaluation, Join a Horizon BCBSNJ or Horizon NJ Health Network (Physicians and Other Healthcare Professionals ), Join the Horizon BCBSNJ Network (Ancillary Providers), Join the Horizon NJ Health Network (Ancillary Providers), BlueCard Medical Policy/Pre-Certification Info, Braven Health℠ Electronic Data Interchange (EDI), Horizon BCBSNJ Electronic Data Interchange (EDI), Prior Authorization/Pre-Service Registration, Specialty Pharmaceuticals for Office Administration, Medicare Advantage Network Plans Overview, Braven Health℠ Plans(Medicare Advantage), New Jersey Infection Prevention Partnership, Remote Patient Monitoring for COPD Provided by HGE Health, Referral Process Using the Interactive Voice Response System, Effective use of the Interactive Voice Response System, Surgical and Implantable Device Management Program, About the Surgical and Implantable Device Management Program, Surgical and Implantable Device Management Program for Cardiac Surgeries Frequently Asked Questions Updated: October 6, 2020, Surgical and Implantable Device Management Program Orthopedic Services Frequently Asked Questions Updated: October 6, 2020, Using Out-of-Network Providers in Surgical Services, CMS Audits to Validate Directory Information, Time Limits for Filing Inquiries/Complaints, Appeals of Non-Utilization Management Determinations, Appeals of Utilization Management/Medical Management Determinations, Appeals of Post Service Medical Necessity Determinations, Allowable Practice Locations for Pathologists, Appointment Availability Access Standards for Primary Care-Type Providers, ObGyns, Specialists and Behavioral Health Providers, Credentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) Providers, Credentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals, EDI and NaviNet Claims Submission Requirement, Material Adverse Change (MAC) Notification Policy, Outlier Audit Programs: Post Payment and Pre-Payment, Physician and Healthcare Professional Counseling and Termination Policy - Professional Competency, Participation Status in Products that Utilize Tiering and/or Subset of an Existing Horizon Network, Practitioner Office Site Quality and Medical Record Keeping Standards, Standards for All Types of Medical and Dental Diagnostic Radiology and Imaging Facilities, Use of Horizon Hospital Network Performance Data, Add-on Payment for COVID-19 Diagnostic Testing Run on High Throughput Technology (U0005), Ambulatory Electrocardiographic Monitoring, Bariatric Surgery Billed With Hiatal Hernia Repair, Billing Guidelines for Maternity Services, Cardiovascular Implant Device Monitoring Services, Claims Requiring Additional Documentation, Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) Supplies, Daily Management of Epidural or Subarachnoid Continuous Drug Administration, Daily Maximum Units for Surgical Pathology and Microscopic Examination, Distinct Procedural Service Modifiers (59, XE, XP, XS, XU), Duplicate Claim Logic for Independent Laboratory Services, Evaluation and Management Services with Chiropractic Manipulative Treatment, Evaluation and Management Services with Osteopathic Manipulative Treatment, Evaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo, Myocardial Profusion Imaging, Frequency of Care Coordination Services and ESRD Procedures, Hospital Non-Patient Laboratory Services Sample Fees, Laser Treatment of Psoriasis or Parapsoriasis, Mutually and Non-Mutually Exclusive NCCI Supplemental Edits, Outpatient Laboratory Claims: Referring Practitioner Required, Physician Extenders Non-Surgical Services, Pre-Payment Documentation Requests: Facility Claims, Post Payment Documentation Requests: Facility Claims, Pulmonary Diagnostic Procedures when billed with E&M Codes, Reimbursement and Billing Guidelines for Anesthesia Claims, Removal of Impacted Cerumen Requiring Instrumentation, Screening and Diagnostic Mammography & 3D Tomosynthesis, Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and products, Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon Medicare Advantage, Urinalysis with Evaluation and Management (E&M) Services, PT/OT Outpatient Prior Authorization for Horizon Medicare Advantage Plans, Prior Authorization Procedure Search Tool, Prior Authorization Requirements for UHH Group #76141(Atlantic City), Prior Authorization Requirements for UHH Group 76215 76315 (New York), Prior Authorization Requirements for UHH Group #s76275 & 76307 (Food Service Plan 376), and UHH Group #s 76305 & 76306 (Food Service Plan 176), Policies, Procedures and General Guidelines, Programs Administered by eviCore healthcare, Participating Physician and Other Health Care Professional Office Manual, Radiation Therapy Medical Necessity Determination, Radiology Professional Group Assessment Tool, Availability of Printed Directories and Web Based Provider Directory Information Through Alternate Media, Requests to Change Provider Directory Content via Electronic Media, Claims Payment Policies and Other Information. Updated Hospital/Ancillary/Professional demographic information feeds automatically to the Doctor & Hospital Finder and is displayed within 24 to 48 hours. NCQA – Current Standards and Guidelines for the Accreditation of Health Plans Visit Blue365. Division of Medical Assistance and Health Services (DMAHS). The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. December. Learn more about Braven Health and your participation status. Hospital quality data from a recognized source. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. Applicable Products: All are independent licensees of the Blue Cross and Blue Shield Association. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Electronic directories will also include search functionality to allow members to customize their provider search, including but not limited to, specialty and geographic area. Review Blue Cross and Blue Advantage medical and pharmacy policies and guidelines or comment on draft policies. Horizon Blue Cross Blue Shield (BCBSNJ) are helping residents of New Jersey by covering the costs of drug or alcohol rehab. You are now leaving Horizon Blue Cross Blue Shield's website for DSM employees. 2020. Back. For questions on the … You are now leaving Horizon Blue Cross Blue Shield's website for DSM employees. Power 2020 award information, visit jdpower.com/awardsjdpower.com/awards opens a dialog window‌. Change improves … Kimberly Ross Manager, Risk Adjustment Provider Education at Horizon Blue Cross Blue Shield of New Jersey Union, New Jersey 500+ connections Exchange POS/EPO, Applicable Products: New Jersey's phased approach to administer COVID-19 vaccines to those who live, work or study in the state is now underway. CMS Managed Care Manual 110.2 Provider Directory Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and … This requirement may be met by establishing a capability of reconstructing a directory as of any date within the prior three years. Even if you’re not a member, you can search for doctors, hospitals and other providers. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. The Credentialing Department creates a file within the appropriate internal system containing the demographic information pertaining to that Hospital/Ancillary/Professional. How do I get a provider directory? Register to attend one of our educational webinars. Procedures: Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. You are now leaving Horizon Blue Cross Blue Shield's website for DSM employees. Or, if you would like to remain in the current site, click Cancel. In the fight against coronavirus (COVID-19), we’re covering more of your patients’ costs and making their access to doctors and nurses easier. Billing for Horizon Blue Cross Blue Shield of New Jersey Home Health Providers Overview General Billing Tips. Dec 2012 – Present 7 years 8 months. Procedure for Creating a New Provider Directory File, Procedure for Existing Hospital/ Ancillary/ Professional Provider Directory Maintenance, Procedure to Ensure Accuracy of Provider Directories, Procedure to Ensure Accuracy of Medicare Advantage Provider Directories. The vendor will create print on demand directories upon request from members, prospective members, network providers and/or internal departments. Policy: 14, 2020 | 11:28 AM America/New_York. … The Hospital/Ancillary/Professional information submitted is reviewed by our Credentialing Committee and a determination is made to accept or deny the request for participation. Or, if you would like to remain in the current site, click Cancel. Three attempts will be made to contact the practitioner in that quarter. Or, click Cancel to remain on the current site. With close to eight million members enjoying the benefits of these health insurance policies, Horizon is one of the most trusted names in the health care industry. HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY MEDICARE PLAN DOCUMENT REQUEST Evidence of Coverage, Formulary, Provider and Pharmacy Directory Now, you have three simple ways to get information you need to take care of your health. Please call Member Services toll free at 1-800-682-9090 Call: 1-800-682-9090 (TTY/TDD 711) to request a copy. Customer Service Representatives can provide information found in our Doctor & Hospital Finder via the telephone, print and mail a subset of the Doctor & Hospital Finder, or mail a printed copy of the entire directory. Statement that the directory was accurate as of the date it was submitted for publication. Some delegated groups are NCQA accredited and have signed agreements to follow Horizon BCBSNJ credentialing administrative policy. Scope: ® 2021 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105. A new Hospital/Ancillary/Professional initiates/submits a request to become a Horizon BCBSNJ participating provider. Member Discounts Take advantage of member-only discounts on health-related products and services. Or, click Cancel to remain on the current site. Please click Continue to leave this website. Provider Directory Providers are added to the network on an ongoing basis or may discontinue their participation in the network. 2 | P a g e EDRC-381 Effective Date: Follow all ICD coding rules. Horizon BCBSNJ will respond in writing within 15 days of receipt of the inquiry disputing the accuracy of the provider information. Tags. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. Providers. ® Registered Marks of Blue Cross Blue Shield of Massachusetts. Horizon BCBSNJ conducts a monthly audit on updated records. Leadership Perspectives. Horizon Blue Cross Blue Shield NJ Doctor & Hospital Finder - Online provider directory for best doctors, dentists, hospitals and PCPs by your location, specialty near you. Horizon BCBSNJ does not credential physicians in delegated groups. Upon receipt of the request, the appropriate department validates or makes the requested changes to the Hospital/Ancillary/Professional record in the appropriate provider files location/system within 20 days of receipt of request. Health Care Costs ; Types of Health Insurance Coverage; Get Free In-Person Help; Glossary; FAQs; Buying a Health Plan . ... Read more. The Blue Cross Blue Shield System is made up of 36 independent and locally operated companies. December. For information on more pharmacies in our plan network not listed in this directory please contact member services at 1-800-391-1906, for TTY/TDD users, 711. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The anticipated date on which the next printed edition will be published. BE100, 10/08. If after the third attempt Horizon in unsuccessful to validate the information the practice will be suppressed from our Online Doctor & Hospital Finder. 25 miles for specialists and ancillary providers. This policy documents the processes and procedures we have in place to ensure that accurate participating provider network data is made available to members enrolled in the plans we offer through the Doctor & Hospital Finder and printed provider directories. Category. ® 2021 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105. Administrative Policy: Provider demographic information will be sent to the contracted vendor on a monthly basis or more frequently as required. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and … COVID19. The Blue Cross® and Blue Shield® names and symbols are … Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. How to Enroll for a Health Plan ; Get a Quote/Browse and Buy … Online Provider Directory Features (OLI Document) Exchange POS/EPO, Applicable Products: This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. Finding and Visiting a Doctor. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its … On a quarterly basis, a Network Outreach Specialist will call practice locations to validate practice’s information. Following the Credentialing Committee approval of a particular Hospital/Ancillary/Professional, the provider files are updated to reflect a participating status. Physicians and other healthcare professionals that cannot be validated through NPPES will be contacted by phone to verify demographic information on a quarterly basis. Please click Continue to leave this website in order to access the Plan Comparison Tool where you can compare medical plan costs. featured . Please note, on the next page, only the information in the yellow box applies to DSM employees -- complete the information required. Connect with us ‌ ‌ ‌ ‌ ‌ Products are provided by Horizon NJ Health. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Marketplace Transparency Purpose: American Well supports Horizon Blue Cross Blue Shield of New Jersey in the administration of telemedicine benefits. Requests to Change Provider Directory Content via Electronic Media Commercial HMO & POS, #1 in Member Satisfaction among Commercial Health Plans in NJ, 3 out of 4 Years, COVID-19 vaccines available in Essex County – Information for your staff and patients, Reimbursement Policy effective January 1, 2021: Add-on Payment for COVID-19 Diagnostic Testing Run on High Throughput Technology (U0005), Update: Members’ cost sharing waived for treatment of COVID-19 through March 2021, COVID-19 vaccines will be covered at 100%, Waiving Prior Authorization Requirements for Emergent In-Network Inpatient Admissions and Post-Acute Facility Admissions, Update: Cost-share waiver for telemedicine and COVID-19 testing extended, Cost Sharing on Claims with Multiple Diagnoses, Dates for Certain Prior Authorization Waivers Further Extended, Dates for Prior Authorization Waivers Extended, New Laboratory COVID-19 Antibody Testing Codes: 86328 and 86769, COVID-19 Update: Medical Policy Revisions & Implementations, 72 Doctors, Nurses, Pharmacists and Health Clinicians from Horizon BCBSNJ Answer Governor Murphy’s “HealthCare Professionals Call to Serve”, New Jersey Pandemic Relief Fund Efforts Get $2 Million Boost from Horizon, A special message from Howard A. Cutler, Vice President, Healthcare Delivery, Behavioral Health Continuity During the COVID-19 Public Health Emergency, Waiving Pre-Certification/Prior Authorization requirements for Physical Health Post-Acute Facility Admissions, Horizon BCBSNJ Commits $2.5 Million for Masks, Face Shields, Food and Social Services to Protect Our Communities and Our Health Professionals, COVID-19 Update: Authorizations Waived for Oxygen Following ER Discharge, Reminder to use specific codes when evaluating for COVID-19, COVID-19 Update: Telemedicine Reimbursement Policy Addenda, Provisionally Join Horizon BCBSNJ Network(s) to Assist with the COVID-19 Pandemic, Waiving Pre-Certification/Prior Authorization requirements for acute inpatient facility admissions, Providing Telephonic care with no costs to members, COVID-19 Response: Eliminating Cost-Sharing for Qualified In-Network Telemedicine Services, Eliminating Cost Sharing Related to COVID-19 Testing and Evaluation, Join a Horizon BCBSNJ or Horizon NJ Health Network (Physicians and Other Healthcare Professionals ), Join the Horizon BCBSNJ Network (Ancillary Providers), Join the Horizon NJ Health Network (Ancillary Providers), BlueCard Medical Policy/Pre-Certification Info, Braven Health℠ Electronic Data Interchange (EDI), Horizon BCBSNJ Electronic Data Interchange (EDI), Prior Authorization/Pre-Service Registration, Specialty Pharmaceuticals for Office Administration, Medicare Advantage Network Plans Overview, Braven Health℠ Plans(Medicare Advantage), New Jersey Infection Prevention Partnership, Remote Patient Monitoring for COPD Provided by HGE Health, Referral Process Using the Interactive Voice Response System, Effective use of the Interactive Voice Response System, Surgical and Implantable Device Management Program, About the Surgical and Implantable Device Management Program, Surgical and Implantable Device Management Program for Cardiac Surgeries Frequently Asked Questions Updated: October 6, 2020, Surgical and Implantable Device Management Program Orthopedic Services Frequently Asked Questions Updated: October 6, 2020, Using Out-of-Network Providers in Surgical Services, CMS Audits to Validate Directory Information, Time Limits for Filing Inquiries/Complaints, Appeals of Non-Utilization Management Determinations, Appeals of Utilization Management/Medical Management Determinations, Appeals of Post Service Medical Necessity Determinations, Allowable Practice Locations for Pathologists, Appointment Availability Access Standards for Primary Care-Type Providers, ObGyns, Specialists and Behavioral Health Providers, Credentialing and Recredentialing Policy for Ancillary and Managed Long Term Support Service (MLTSS) Providers, Credentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals, EDI and NaviNet Claims Submission Requirement, Material Adverse Change (MAC) Notification Policy, Outlier Audit Programs: Post Payment and Pre-Payment, Physician and Healthcare Professional Counseling and Termination Policy - Professional Competency, Participation Status in Products that Utilize Tiering and/or Subset of an Existing Horizon Network, Practitioner Office Site Quality and Medical Record Keeping Standards, Standards for All Types of Medical and Dental Diagnostic Radiology and Imaging Facilities, Use of Horizon Hospital Network Performance Data, Add-on Payment for COVID-19 Diagnostic Testing Run on High Throughput Technology (U0005), Ambulatory Electrocardiographic Monitoring, Bariatric Surgery Billed With Hiatal Hernia Repair, Billing Guidelines for Maternity Services, Cardiovascular Implant Device Monitoring Services, Claims Requiring Additional Documentation, Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) Supplies, Daily Management of Epidural or Subarachnoid Continuous Drug Administration, Daily Maximum Units for Surgical Pathology and Microscopic Examination, Distinct Procedural Service Modifiers (59, XE, XP, XS, XU), Duplicate Claim Logic for Independent Laboratory Services, Evaluation and Management Services with Chiropractic Manipulative Treatment, Evaluation and Management Services with Osteopathic Manipulative Treatment, Evaluation and Management Services billed with Global Radiology, Stress Test, Stress Echo, Myocardial Profusion Imaging, Frequency of Care Coordination Services and ESRD Procedures, Hospital Non-Patient Laboratory Services Sample Fees, Laser Treatment of Psoriasis or Parapsoriasis, Mutually and Non-Mutually Exclusive NCCI Supplemental Edits, Outpatient Laboratory Claims: Referring Practitioner Required, Physician Extenders Non-Surgical Services, Pre-Payment Documentation Requests: Facility Claims, Post Payment Documentation Requests: Facility Claims, Pulmonary Diagnostic Procedures when billed with E&M Codes, Reimbursement and Billing Guidelines for Anesthesia Claims, Removal of Impacted Cerumen Requiring Instrumentation, Screening and Diagnostic Mammography & 3D Tomosynthesis, Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and products, Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon Medicare Advantage, Urinalysis with Evaluation and Management (E&M) Services, PT/OT Outpatient Prior Authorization for Horizon Medicare Advantage Plans, Prior Authorization Procedure Search Tool, Prior Authorization Requirements for UHH Group #76141(Atlantic City), Prior Authorization Requirements for UHH Group 76215 76315 (New York), Prior Authorization Requirements for UHH Group #s76275 & 76307 (Food Service Plan 376), and UHH Group #s 76305 & 76306 (Food Service Plan 176), Policies, Procedures and General Guidelines, Programs Administered by eviCore healthcare, Participating Physician and Other Health Care Professional Office Manual, Radiation Therapy Medical Necessity Determination, Radiology Professional Group Assessment Tool. Review information about the Horizon Behavioral Health program. This policy applies to processes that ensure that accurate participating provider network information is made available to members enrolled in all of the plans and products we offer, including QHP plans and products, in a reasonable timeframe through our online Doctor & Hospital Finder and our printed provider directories. ® Registered Marks of the Blue Cross and Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. Please click Continue to leave this website in order to access the Plan Comparison Tool where you can compare medical plan costs. The physician record attestation date is equivalent to the outreach date. 877-860-2837 (Blue Cross Community Health Plans) 877-723-7702 (Blue Cross Community MMAI) 877-774-8592 (Blue Cross Medicare Advantage) 800-676-2583 (Eligiblity - Out of State BCBS) 800-972-8382 (Eligibility - FEP) Indiana: 888-802-2160 855-251-8827 (Health Maintenance Organization) 855-558-1438 (L Preferred Provider Organization) Directory Requirements You know what it takes to keep … The Provider Data Management Department conducts a quarterly physician outreach. Requests may be initiated via our online Demographic Update tool, by completing and submitting a copy of our File Change Request Form, or by submitting a letter on the practice’s or facilities letterhead. You are now leaving Horizon Blue Cross Blue Shield's website for DSM employees. Availability of Printed Directories and Web Based Provider Directory Information Through Alternate Media To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. This website does not display all Qualified Health Plans available through Get Covered NJ. New Hospital/Ancillary/Professional information is displayed within the Doctor & Hospital Finder within 24 to 48 hours. Horizon BCBSNJ will retain as business records copies of each version of its printed provider directory for at least three years from the publication date. Table of Contents BCBSNC … Horizon BCBSNJ accepts directory maintenance files to update demographic information and participation status of practitioners. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and … Commercial PPO/EPO & Commercial PPO/EPO & The Doctor & Hospital Finder and printed directories will contain the following fields for each provider as required by CMS, DOBI and NCQA: The electronic directories will be published in a JavaScript Object Notation (JSON) Format, also known as a machine readable format. The appropriate Contracting/Credentialing Department ensures that all required information is received to allow the contracting/credentialing team to conduct a complete review of the submitted information. Horizon Blue Cross Blue Shield of NJ. Blue365's® exclusive deals, open only to Blue members, will bring you discounts at top health and wellness retailers around the country. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Horizon BCBSNJ will not display any practitioner information within our Online Doctor & Hospital Finder that are unable to be validated. Power 2020 award information, visit jdpower.com/awards. You have until January 31, 2021 to apply for Individual health care coverage effective February 1, 2021. You are leaving the Horizon Blue Cross Blue Shield of New Jersey website. This policy applies to demographic information pertaining to newly contracted or credentialed physicians, other healthcare professionals, facilities and ancillary providers as well as changes to the demographic information pertaining to existing participating physicians, other healthcare professionals, facilities and ancillary providers. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Please click Continue to leave this website in order to access the Plan Comparison Tool where you can compare medical plan costs. Provider Directory Management. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. If you need help, we’ve created these helpful guides: Step-by-Step PDF; Search as Guest × Footer Skip to footer content. A statement that more current directory information is available on the carrier’s electronic directory available on the carrier’s website. Upon request from members, prospective members, prospective members, horizon blue cross blue shield provider directory members, will bring you at! 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Shield always tries to show the most up-to-date provider information Strong and stand together the Benefit of Blue℠ is service... Agreements to Follow Horizon BCBSNJ conducts a quarterly physician outreach box applies to DSM employees for Orthopedic Specialists updates. For Orthopedic Specialists blue365's® exclusive deals, open only to Blue members, prospective members, will bring you at... Types of Health Insurance Marketplace discounts Take advantage of member-only discounts on health-related products and services audit on records... ® SM registered and service marks of Horizon Blue Cross Blue Shield.... Approval of a particular Hospital/Ancillary/Professional, the provider Data Management Department conducts quarterly. Of a particular Hospital/Ancillary/Professional, the appropriate files Department saves the updates made exclusive deals, open to... Blue Shield® names and symbols are registered marks of the Blue Cross® and Blue Shield BCBSNJ.

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