PRIOR AUTHORIZATION/MEDICAL NECESSITY DETERMINATION PRESCRIBER FAX FORM Only the prescriber may complete this form. This form is for prospective, concurrent, and retrospective reviews. ... the original message to Horizon Blue Cross Blue Shield of New Jersey . 6328 NJNR COEX PRIME THERAPEUTICS LLC 06/17. Horizon …Application - Appeal a Claims Determination. Use this form to appeal a medical claims determination by Horizon BCBSNJ (or its contractors) on previously-submitted claims, or to appeal an apparent lack of action toward resolving a previously-submitted claim. Do not use this form for dental appeals. ID: DOBICAPPCAR.Authorization Forms Third Party Designee Appointment / Acceptance This form allows members who are enrolled in a Horizon BCBSNJ commercial product, and are age 62 years or older, to designate an additional person to receive a copy of certain notices. ID: 32316 Forms and documents related to requesting or providing authorization.Beginning September 1, 2019 , requests for Precertification/Prior authorization must be submitted through CareAffiliate or by calling 1-800-682-9094 , Monday through Friday, …If you need help understanding this Horizon Blue Cross Blue Shield of New Jersey information, you have the right to get help in your language at no cost to you. To talk to an interpreter, please call 1-800-355-BLUE (2583) during normal business hours. Spanish (Español): Si necesita ayuda para comprender esta información de Horizon Blue CrossHorizon NJ TotalCare (HMO D-SNP) is the FIDE-SNP plan under Horizon Blue Cross Blue Shield of New Jersey. Horizon NJ TotalCare (HMO D-SNP) coordinates all Medicaid and Medicare managed care benefits, including primary care and preventive services, behavioral health and long-term care. Members will receive quality care designed to meet all of ...Your primary care physician or specialist may obtain prior authorization for you by calling 1 - 8 0 0 - 6 6 4 - 2 5 8 3 ( TTY 711 ). You can sign in to see what services require prior authorization. Was this helpful? Last updated: Jan 11,2022 Category: Benefits & Coverage Topic: Authorizations & Referrals Related FAQs What is prior authorization?State of New Jersey Contractual Requirements. Surgical and Implantable Device Management Program. Timely Filing Requirements. Utilization Management. Digital Member ID Cards. COVID-19. Stay informed. Get the latest information on COVID-19.THIS DRUG LIST (FORMULARY) APPLIES TO HORIZON BCBSNJ'S HEALTH INSURANCE MARKETPLACE INDIVIDUAL AND SMALL GROUP MEDICAL PRODUCTS. THE APPLICABLE PRODUCTS FOR THE INDIVIDUAL MARKEHorizon Pharmacy is committed to providing our members with access to safe and effective medicines. This list of medicines require Prior Authorization/Medical Necessity Determination. This means that your doctor must give us information to show the use of the medicine meets specific criteria. The criteria follow U.S. Food and Drug Administration (FDA)-approved product labeling and generally ...Pharmacy Utilization Management Programs. Pharmacy Medical Necessity Determination. Maximum Allowable Cost (MAC) Appeal Form. Policies. Provider Administrative Manual. State of New Jersey Contractual Requirements. Surgical and Implantable Device Management Program. Timely Filing Requirements. Utilization …NJ FamilyCare Renewal Information. Pharmacy Utilization Management Programs. Pharmacy Medical Necessity Determination. Maximum Allowable Cost (MAC) Appeal Form. Policies. Provider Administrative Manual. State of New Jersey Contractual Requirements. Surgical and Implantable Device Management Program. Timely Filing Requirements.Horizon BCBSNJ will update the list of site of service procedures with any new codes released in subsequent years that have a site of service differential. The table below¹ includes current national place of service code set information that identifies the facility and non-facility designations for each code. POS Code. POS Name. Payment Rate. 01.2 Essential Details Proprietary & Confidential Effective August 23, 2018, all Horizon member prior authorizations requests for Physical Therapy and Occupational Therapy services should be submitted via the online Utilization Management Request Tool (Care Affiliate) accessible on NaviNet®.This is the preferredPre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions Pre-Certification/Prior Authorization requirements for Post ... Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc., each an ...Prior Authorization/Medical Necessity Determination medicine list Horizon Blue Cross Blue Shield of New Jersey Pharmacy is committed to providing our members with access to safe and effective medicines. Below you will find a list of medicines requiring Prior Authorization/Medical Necessity Determination.Horizon BCBSNJ offers competitive pay, the opportunity for growth, a collaborative and diverse workforce, convenient office locations, and a variety of benefits including paid volunteer hours, state of the art gym, and much more. ... and much more. Horizon Blue Cross Blue Shield of New Jersey is an independent licensee ...COVID-19 Stay informed. Get the latest information on COVID-19. Prior Authorization You can look up CPT or HCPCS codes to determine if a medical, surgical, or diagnostic service requires prior authorization for a Horizon member.PRIOR AUTHORIZATION/MEDICAL NECESSITY DETERMINATION PRESCRIBER FAX FORM Only the prescriber may complete this form. This form is for prospective, concurrent, and retrospective reviews. Incomplete forms will be returned for additional information. Start saving time today by filling out this prior authorization form electronically. Visit Service Coordination Process Horizon BCBSNJ Plans Coordinated Requests to arrange for the above services are submitted through ECIN/Allscripts, fax or phone to CareCentrix. CareCentrix registers the case request in its system and undertakes arranging for service delivery. Services that are subject to prior authorization arePre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions Pre-Certification/Prior Authorization ... Horizon NJ Health uses the care guidelines from MCG Health to make behavioral health care utilization ... Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company ...Horizon MyWay – PPO Plan Design. The Horizon MyWay PPO product combines a high-deductible PPO plan with a medical account. This health plan offers in- and out-of-network benefits and covers preventive care at 100 percent in network. Members can maximize benefits by using participating PPO providers.Last updated on: June 16, 2022, 07:13 AM ET. We're pleased to announce that you can now use our Prior Authorization Procedure Search Tool to determine if services require prior authorization (PA) for your patients enrolled in Horizon NJ Health and Horizon NJ TotalCare (HMO D-SNP) plans.THIS DRUG LIST (FORMULARY) APPLIES TO HORIZON BCBSNJ'S HEALTH INSURANCE MARKETPLACE INDIVIDUAL AND SMALL GROUP MEDICAL PRODUCTS. THE APPLICABLE PRODUCTS FOR THE INDIVIDUAL MARKETo determine which drugs are covered and to request prior authorizations, access our Drug Authorization tool on NaviNet. Sign on to NaviNet and access Drug Authorizations from the Horizon BCBSNJ Plan Central page, under Work Flows. If you need access to the Drug Authorization tool, please work with your office’s NaviNet Security Officer to ...Authorizations for your patients enrolled in Horizon NJ Health (Medicaid) and Horizon NJ Total Care (HMO D-SNP) plans are required for Physical Therapy and Occupational Therapy (PT/OT) rendered in the following settings: Home. Office. Outpatient hospital. Comprehensive outpatient rehab facilities. Authorization is not required for participating ...Suggesting a visit to a dentist is mandatory at 3 years of age and once every six months thereafter up to age 21 years. Claims must be submitted with EPSDT codes. Include your provider number on the CMS claim form/claims submission. The applicable codes are listed in section 5.3 of the Provider Administrative Manual.Authorizations for your patients enrolled in Horizon NJ Health (Medicaid) and Horizon NJ Total Care (HMO D-SNP) plans are required for Physical Therapy and Occupational Therapy (PT/OT) rendered in the following settings: Home. Office. Outpatient hospital. Comprehensive outpatient rehab facilities. Authorization is not required for participating ...authorization request has been denied by Blue Cross or BCN. The purpose of a peer-to-peer review of a determination on either an inpatient or outpatient prior authorization request is to exchange information about the clinical nuances of the member's medical condition and the medical necessity of the services.This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue ...Home › Members Medical policies and prior authorizations What are prior authorizations and medical policies? Horizon BCBSNJ's medical policy follows established clinical and preventive guidelines, so when you need care, you have access to the most appropriate options.Apr 4, 2016 · Access the Prior Authorization Procedure Search tool here or through links on the Horizon BCBSNJ plan central page of NaviNet® NaviNet® opens a dialog window. The tool, as well as certain prior authorization lists for ASO member groups, is accessible on the Prior Authorization page of HorizonBlue.com. To determine if a patient is fully ... Pre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions Pre-Certification/Prior Authorization requirements for Post ... Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc., each an ...Mar 25, 2021 · Application - Appeal a Claims Determination. Use this form to appeal a medical claims determination by Horizon BCBSNJ (or its contractors) on previously-submitted claims, or to appeal an apparent lack of action toward resolving a previously-submitted claim. Do not use this form for dental appeals. ID: DOBICAPPCAR. Provider communications resources. You know all too well that many people forget about — or avoid — their annual wellness visits and screenings. That’s why, a friendly reminder from their trusted doctor can encourage them to schedule a visit. Use the communications materials below to help remind your patients about important health …This material is presented to ensure that Physicians and Health Care Professionals have the information required to provide benefits and services for Horizon NJ Health members. Additional materials are available for participating providers at Navinet.net. If you require hard copies of any of this information please call the Physician and Health Care Hotline at 1-800-682-9091.Horizon BCBSNJ pharmacy policies do not constitute medical advice, authorization, certification, approval, explanation of ... The purpose of this policy is to set forth the policy and procedure for the Pharmaceutical Prior Authorization process for Horizon BCBSNJ prescription drug coverage that requires pharmaceutical prior authorization for ...State of New Jersey Contractual Requirements. Surgical and Implantable Device Management Program. Timely Filing Requirements. Utilization Management. Digital Member ID Cards. COVID-19. Stay informed. Get the latest information on COVID-19.Once you select the service you are looking for, check the column titled Prior Authorization to see if it's required for this benefit. Your doctor or hospital is responsible for requesting prior authorization for you. ... Horizon BCBSNJ Employees ; Horizon BCBSNJ Retirees ; Transparency in Coverage ® 2023 Horizon Blue Cross Blue Shield of New ...Provider Data Maintenance Tool - Your NaviNet Security Officer can access the Provider Data Maintenance Tool to quickly and conveniently make changes to your provider information which we display to your Horizon BCBSNJ and Horizon NJ Health patients. Referrals & Authorizations - Access our Medical Policies or prior authorization process and ...Horizon Blue Cross Blue Shield of New Jersey collaborates with Magellan Rx Management to manage our Medical Injectables Program (MIP). Magellan Rx Management, a specialty pharmaceutical management company, conducts medical necessity and appropriateness reviews (MNARs) for specific injectable medications in …Copyright © 2023 All rights reserved. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. Feedback ...Allow the doctor's office and Horizon BCBSNJ enough time to complete this process. Check back with the pharmacy to see if the prior authorization was approved. If the medicine is not approved, refer to the written authorization that was received or will be received in the mail. It includes all the relevant information necessary to continue ...Horizon BCBSNJ: Uniform Medical Policy Manual: Section: Drugs: Policy Number: 153: Effective Date: 09/11/2020: ... authorization, certification, approval, explanation of benefits, offer of coverage, contract or guarantee of payment. ... Provide proper training to patients and/or caregivers on the preparation and administration of DUPIXENT prior ...Request for Continuance of Enrollment for Disabled Dependent. Members with a mentally-impaired or physically-disabled child can use this form to request that the child continues to be covered by the parent’s dental plan. ID: 9429. Attention SHBP/SEHBP members: You must use the SHBP/SEHBP Continuance of Enrollment application instead of this form. Horizon Pharmacy is committed to providing our members with access to safe and effective medicines. This list of medicines require Prior Authorization/Medical Necessity Determination. This means that your doctor must give us information to show the use of the medicine meets specific criteria. The criteria follow U.S. Food and Drug Administration (FDA)-approved product labeling and generally ...Horizon BCBSNJ's prior authorization requirements remain unchanged for specific services rendered in the outpatient setting and billed with place of service code 22. As a reminder, it is the ordering physician's responsibility to obtain this prior authorization. CHIROPRACTIC CLAIMS.Always carry your current BlueCross card for easy reference and access to service. In an emergency, go directly to the nearest hospital. To find nearby doctors and hospitals, access the Find a Doctor or Hospital tool or call BlueCard Access at 1-800-810-BLUE.If you have questions, please speak with a Physician Services representative at 1-800-624-1110 or an Institutional Services representative at 1-888-666-2535, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time. This year, NaviNet® released several enhancements that will provide Horizon Blue Cross Blue Shield of New Jersey's ...Horizon CareOnline. Horizon BCBSNJ now makes it easy for you to stay in control of your health. Eligible members can use Horizon CareOnline to talk with a U.S. board-certified, licensed doctor via video, chat or phone, 24 hours a day, seven days a week — no appointment needed.Horizon BCBSNJ: Uniform Medical Policy Manual: Section: Drugs: Policy Number: 045: Effective Date: 02/14/2020: Original Policy Date: 10/27/2006: Last Review Date: ... The requirements of the Horizon BCBSNJ Immune Globulin Subcutaneous Program may require a precertification/prior authorization via MagellanRx Management.Mar 25, 2021 · 40001_ABA_Auth_Info.pdf. Behavioral Health providers may use this form for both initial and concurrent requests for authorization of ABA services. ID: 40001. Prior Authorization Procedure Search Tool. Use our Prior Authorization Procedure Search Tool, available 24/7, to determine if you need to get prior authorization (PA) before providing services to your patients enrolled in our fully insured commercial plans, Braven Health℠ Medicare Advantage plans and the State Health Benefit Program (SHBP ...Find Covered Prescription Drugs. Find formulary drugs, prior authorization, and step therapy at Prime Therapeutics. Plan Year. To get started, select the year for your plan's coverage from the dropdown menu. Choose Your Plan. Select the type of plan you want from this dropdown menu. Find Drugs.Horizon Pharmacy is committed to providing our members with access to safe and effective medicines. This list of medicines require Prior Authorization/Medical Necessity Determination. This means that your doctor must give us information to show the use of the medicine meets specific criteria. The criteria follow U.S. Food and Drug Administration (FDA)-approved product labeling and generally ...Dawn, also known as daybreak, is the time of morning when the first light appears in the sky prior to sunrise, which is the appearance of the top of the sun over the horizon. Dawn occurs roughly 30 minutes before sunrise at sea level.We're pleased to announce that you can now also use our Prior Authorization Procedure Search Tool to determine if services require prior authorization (PA) for your patients enrolled in Horizon Medicare Advantage, Braven Health, Horizon NJ Health and Horizon NJ TotalCare (HMO D-SNP) plans. Simply enter a CPT® or HCPCS code to see if that service requires PA in a variety of settings.authorization request has been denied by Blue Cross or BCN. The purpose of a peer-to-peer review of a determination on either an inpatient or outpatient prior authorization request is to exchange information about the clinical nuances of the member's medical condition and the medical necessity of the services.Horizon NJ Health is part of the Horizon Blue Cross Blue Shield of New Jersey enterprise, an independent licensee of the Blue Cross and Blue Shield Association. ? 2017 Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey 07105. Para recibir una copia de esta carta en espa?ol, llame gratis al 1-800-682-9094Prior Authorization You can look up CPT or HCPCS codes to determine if a medical, surgical, or diagnostic service requires prior authorization for a Horizon member. This application only applies to Commercial Fully Insured, New Jersey State Health Benefits Program (SHBP) or School Employees' Health Benefits Programs (SEHBP), Braven Health ...This policy outlines Horizon BCBSNJ’s reimbursement policy for radiopharmaceuticals and contrast material. Products where Horizon BCBSNJ is secondary to Medicare (e.g. Medigap). All Insured and Administrative Services Only (ASO) accounts are included. All professional providers will be reimbursed based on this policy for the …Horizon BCBSNJ makes benefit determinations based on the medical policies in existence at the time Horizon BCBSNJ receives a request (e.g., prior authorization or prior determination) or based on the actual date of service on a claim for the service, treatment, procedure, equipment, device, supply, or drug. Horizon BCBSNJ …Consent Form - Representation in Appeals. This form provides or revokes consent to representation in an appeal of an adverse UM determination, as allowed by N.J.S.A. 26:25-11, and release of personal information to DOBI, its contractors for the Independent Health Care Appeals Program, and independent contractors reviewing the appeal.Up to $1,600 annually ($400 per quarter) in OTC benefits. There are hundreds of items to choose from. Eligible members get up to an extra $300/year ($75 per quarter) to help pay your electricity, water or gas utility bills.*. Get 24/7 online doctor and therapist visits (telehealth) using your phone, tablet or computer with Horizon CareOnline℠.Tell Horizon BCBSNJ if you have other health insurance coverage. Use our tools and resources to understand your plan and the insurance process. View and print your member ID card. View your benefit information. View your out-of-pocket expenses, authorizations, referrals and other account information. ...NJ FamilyCare Renewal Information. Pharmacy Utilization Management Programs. Pharmacy Medical Necessity Determination. Maximum Allowable Cost (MAC) Appeal Form. Policies. Provider Administrative Manual. State of New Jersey Contractual Requirements. Surgical and Implantable Device Management Program. Timely Filing Requirements.When you become eligible for Medicare, you have options for controlling your out-of-pocket health care expenses - the costs that Original Medicare does not cover. Horizon BCBSNJ offers a choice of affordable health care plans to meet your budget and health care needs. https://medicare.horizonblue.com. You've worked hard to get where you are ...Pre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions Pre-Certification/Prior Authorization requirements for Post ... Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc., each an ...Horizon Blue Cross Blue Shield of New Jersey collaborates with Magellan Rx Management to manage our Medical Injectables Program (MIP). Magellan Rx Management, a specialty pharmaceutical management company, conducts medical necessity and appropriateness reviews (MNARs) for specific injectable medications in accordance with Horizon BCBSNJ's medical policy criteria and guidelines when provided ...All Horizon BCBSNJ's plans that include behavioral health benefits through the Horizon Behavioral Health program will now be managed by our internal staff. Below are answers to questions you may have about the changes to the management of the Horizon Behavioral Health program and the day-to-day operations. Q1.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 Blue Shield Association.Horizon BCBSNJ contracts with TurningPoint Healthcare Solutions, LLC (TurningPoint) to manage this Program. TurningPoint conducts Prior Authorization & Medical Necessity Determination (PA/MND) reviews of certain orthopedic services and cardiac services (many of which include implantable devices), and other related services, …Horizon BCBSNJ medical policies do not constitute medical advice, authorization, certification, approval, explanation of benefits, offer of coverage, contract or guarantee of payment. Lumbar spinal fusion (arthrodesis) is a surgical technique that involves fusing 2 or more lumbar vertebrae using local bone, autologous bone taken from the iliac crest of the …Horizon BCBSNJ’s online tool helps make it easier for you to determine if services require prior authorization for your fully-insured Horizon BCBSNJ patients. Our Prior …Horizon Managed Care Network and/or Horizon PPO Network: 1-800-624-1110, weekdays, from 8 a.m. to 5 p.m., Eastern Time (ET) Horizon NJ Health networks: 1-800-682-9091, weekdays, from 8 a.m. to 5 p.m., ET. Behavioral health providers can also send an email to [email protected]. Please include your name, NPI and county. NaviNet ...Medical Injectables Program Update: May 10, 2023. Horizon collaborates with Magellan Rx Management (MRxM) to administer its Medical Injectables Program (MIP). As part of our shared commitment to help ensure that the medications our members need are medically necessary and cost effective, the following changes will be made to our MIP. Injectable ...Find Horizon Blue Cross Blue Shield New Jersey (BCBSNJ) address, contact numbers, ... OMNIA Health Plans, NJ DIRECT and Horizon HMO (PPO) plans Horizon Blue Cross Blue Shield of New Jersey PO Box 820 Newark, NJ 07101-0820. PLEASE NOTE Participating health care professionals should file medical claims directly with their local …PRIOR AUTHORIZATION/MEDICAL NECESSITY DETERMINATION PRESCRIBER FAX FORM Only the prescriber may complete this form. This form is for prospective, concurrent, and retrospective reviews. Incomplete forms will be returned for additional information. Start saving time today by filling out this prior authorization form electronically. VisitPharmacy Prior Authorization (PA) ensures appropriate utilization of certain drugs, promotes treatment protocols and generic drug utilization, actively manages prescription drugs with serious side effects and positively influences the process of managing prescription drug costs. ... Prior to referring a Horizon BCBSNJ member for out-of-network ...Horizon Blue Cross Blue Shield of New Jersey Musculoskeletal Program Spine Surgery Procedure Code Listing eviCore conducts Prior Authorization and Medical Necessity Determination (PA/MND) reviews of the procedure codes listed below as part of our Musculoskeletal Program for Spine Surgery Services. 0274T 22534 22850 63048 63251Your Horizon plan requires you to receive prior authorization or a referral for certain services or treatments. Sign in and take a look at the Explanation of Benefits (EOB) statement when you click the Claim Details hyperlink, then View Explanation of Benefits.. If it includes the Message Code M737 that means your claim has been denied because there was no prior authorization or referral on ...Horizon Pharmacy is committed to providing our members with access to safe and effective medicines. This list of medicines require Prior Authorization/Medical Necessity Determination. This means that your doctor must give us information to show the use of the medicine meets specific criteria. The criteria follow U.S. Food and Drug Administration (FDA)-approved product labeling and generally ...Workers' Compensation & Personal Injury. Coverage Outside of New Jersey. 24/7 Nurse Line. AbilTo Support Program. Balance Living. Case Management. Chronic Care Program. Identity Protection Services. Horizon CareOnline.Horizon's goal is to provide prompt responses to your inquiries and timely resolution of complaints brought to our attention. Call our Interactive Voice Response (IVR) system at 1-888-666-2535 to access the information you need concerning your inquiries or complaints. In addition, our Centralized Service Center (CSC) Phone Unit is available to …Find formulary drugs, prior authorization, and step therapy at Prime Therapeutics. Plan Year To get started, select the year for your plan's coverage from the dropdown menu. Choose Your Plan Select the type of plan you want from this dropdown menu. Find Drugs CONTACT US Need help enrolling? 1-877-234-1240 (TTY call 711)By providing a health care experience that is comprehensive, integrated and simple to navigate, Braven Health is a new way to health for a new generation of Medicare members," said Gary D. St. Hilaire, president and CEO of Horizon BCBSNJ. "This partnership is the culmination of years of work together with partners that possess a shared ...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 Blue Shield Association. Prior authorization is the written approval from Horizon, prior to the date of, To determine which drugs are covered and to request prior authorizations, ac, As the state's largest and most experienced health insurer, Horizon B, PRIOR AUTHORIZATION/MEDICAL NECESSITY DETERMINATION PRESCRIBER, PO Box 25. Newark NJ 07101-0025. Behavioral Health (including mental hea, Specialty Rx Program for Infertility Treatment. To get the most from in-network benefits, 1-888-456-2415 Prior Authorization Requests for Speech Therapy. 1-888-891-8913 Precertification Re, Your Horizon BCBSNJ plan may include prescription coverage through th, Some medicines have special requirements where you, Medical Day Care (MDC) Authorization Request Form , Changes to Provider Demographic Information. To remind providers , Prior to referring a Horizon BCBSNJ member for out-of-network , Specialty Rx Program for Infertility Treatment. To g, Orthopedic Services. TurningPoint is contracted to manage PA/MND rev, Toggle menu. BACK back to www.horizonblue.com; PROVIDERS ; COVID-19 , Utilization Management Request Tool. Submit authorization , Clinical Authorization Forms. COVID Vaccine Form. Early and Period, Please use our Prior Authorization Procedure Search Tool to determine .