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Medical Policies - Horizon Blue Cross Blue Shield of …

    https://www.horizonblue.com/providers/policies-procedures/policies/medical-policies/policyterms?destination=/providers/policies-procedures/policies/medical-policies/search/keyword-all
    The purpose of the Horizon Medical Policy Manual is to provide clinical policies applicable to the administration of health benefits insured or administered by Horizon Blue Cross Blue Shield of New Jersey, Horizon Healthcare of New Jersey, Inc., Horizon Insurance …

Medical policies and prior authorizations - Horizon Blue …

    https://www.horizonblue.com/members/education-center/medical-policies-and-prior-authorizations
    Horizon BCBSNJ’s medical policy follows established clinical and preventive guidelines, so when you need care, you have access to the most appropriate options. Our …

Horizon Blue Cross Blue Shield of New Jersey (Horizon …

    https://www.horizonblue.com/
    All Horizon health insurance plans include the following essential health benefits: Outpatient services, such as diagnostic tests and minor surgeries Emergency services …

BCBSNJ Medical Policy for - (Drugs) Policy Number - 142

    https://services3.horizon-bcbsnj.com/hcm/MedPol2.nsf/MedicalPolicies/KKPR-AC8LPG
    This Horizon BCBSNJ Medical Policy (the “Medical Policy”) has been developed by Horizon BCBSNJ’s Medical Policy Committee (the “Committee”) consistent with generally …

BCBSNJ Medical Policy for - (Medicine) Policy Number - 091

    https://services3.horizon-bcbsnj.com/hcm/MedPol2.nsf/MedicalPolicies/RFMI-B82FPV
    This policy is not intended to direct the course of clinical care a physician provides to a member, and it does not replace a physician’s independent professional clinical judgment …

Bundled Services - Horizon Blue Cross Blue Shield of …

    https://www.horizonblue.com/providers/policies-procedures/policies/reimbursement-policies-guidelines/outpatient-facility-code-edits-bundling-and-revenue-codes/bundled-services
    Bundled Services - Horizon Blue Cross Blue Shield of New Jersey › COVID-19 Stay informed. Bundled Services These procedure codes will not be considered for …

BCBSNJ Medical Policy for - (Surgery) Policy Number - 164

    https://services3.horizon-bcbsnj.com/hcm/MedPol2.nsf/MedicalPolicies/DDIL-AWLLN7
    Horizon BCBSNJ medical policies do not constitute medical advice, authorization, certification, approval, explanation of benefits, offer of coverage, contract or …

BCBSNJ Medical Policy for - (Surgery) Policy Number - 022

    https://services3.horizon-bcbsnj.com/hcm/MedPol2.nsf/MedicalPolicies/TKEN-6SKN7T
    Horizon BCBSNJ medical policies do not constitute medical advice, authorization, certification, approval, explanation of benefits, offer of coverage, contract or …

Claims Submission and Reimbursement - Horizon Blue Cross …

    https://www.horizonbluestaging.com/providers/resources/manuals-user-guides/hospital-manual/claims-submission-and-reimbursement
    When the patient’s primary insurance is traditional Medicare, claims are sent to Horizon BCBSNJ from CMS national crossover contractor, the Benefits Coordination & Recovery …

Home - SHBP/SEHBP - Horizon Blue Cross Blue Shield …

    https://www.horizonblue.com/shbp/
    The Direct Primary Care Program is offered to active employees and non-Medicare retirees who are enrolled in SHBP/SEHBP’s NJ DIRECT Plan or OMNIA℠ Health Plan. Horizon Health Guide You’ll get the most from …



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