Horizonnjhealthstaging.com

Clinical Guidelines

WEBMembers and providers can obtain a copy of the benefit provision, guideline, protocol or other criteria on which decisions are based at no cost by contacting Horizon NJ Health …

Actived: 7 days ago

URL: https://www.horizonnjhealthstaging.com/for-providers/resources/clinical-and-preventive-guidelines/clinical-guidelines

Medicaid Provider Enrollment Requirements by State

WEBa {word-wrap:break-word !important;} span {word-wrap:break-word !important;} The following information includes state-specific provider enrollment requirements for states …

Category: Health Go Health

Updates and Announcements

WEBToggle menu. BACK back to www.horizonblue.com; PROVIDERS ; COVID-19 Information COVID-19 Information. COVID-19 Information ; Coverage for Out-of …

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Helping Patients Understand Their Care

WEBWhat you can do: Create a safe environment where patients feel comfortable talking openly with you. Encourage patients to bring a friend or relative to appointments for support. Sit …

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eviCore healthcare

WEBHorizon NJ Health partners with eviCore healthcare (eviCore) to manage Advanced Imaging Services for our members through Prior Authorizations/Medical Necessity …

Category: Medical Go Health

Pharmacy Medical Necessity Determination

WEBTo obtain prior authorization, or for printed copies of any pharmaceutical management procedure, please call our Pharmacy Department at 1-800-682-9094. Prior authorization …

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Transitional Care Planning

WEBHorizon NJ Health shall reimburse physicians and non-physician practitioners for transactional care planning codes (CPT codes 99495 and 99496) once per member …

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Tip Sheet – Documentation of Medical Care

WEBHealth education/anticipatory guidance (age appropriate anticipatory guidance [AG] or anticipatory guidance given [AGG] are acceptable) Completed immunization record; …

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Managed Medicaid Policy for Physical and Occupational Therapy …

WEBHabilitative – Habilitation refers to health care services that help a person acquire keep or improve, partially or fully, and at different points in life, skills related to …

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Horizon Pulse November 2023

WEBHorizon NJ Health's Care Management programs offer services specific to a member's physical and behavioral health needs to align with their primary diagnosis or acute care …

Category: Health Go Health

Radiation Therapy

WEBStereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions. 77385. Intensity …

Category: Course Go Health

Horizon Behavioral Health Program

WEBThe Horizon Behavioral Health℠ program supports our members in getting access to safe and effective mental health and Substance Use Disorder care. The program ensures …

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Federally Qualified Health Center (FQHC) Resource Guide

WEBTo file a claim appeal, a physician or health care professional must send the appeal application form and any supporting documentation to Horizon NJ Health using one of …

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Availity Essentials™ Is Your New Provider Portal

WEBAfter May 31, 2024, you’ll no longer be able to use NaviNet for Horizon, Braven Health or Horizon NJ Health plans. Register and begin using Availity Essentials …

Category: Health Go Health

Medical Policy Revision: Applied Behavior Analysis in the …

WEBEffective July 3, 2023, we will revise our Applied Behavior Analysis in the Treatment of Autism Spectrum Disorders (ASD) medical policy.. These revisions - designed to help …

Category: Medical Go Health

Home Health Certification and Re-Certification

WEBEffective Date: December 1, 2020 Purpose: This policy provides reimbursement guidelines for billing of physician certification and re-certification for Medicare-covered home health …

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Digital Member ID Cards

WEBYour staff may be in the habit of asking for a physical member ID card to make copies or verify benefit and cost share information. But if your Horizon NJ Health members …

Category: Health Go Health

Primary Care Providers, Have Your Patients Had Their Annual …

WEBIf your Horizon NJ Health patients haven’t seen you for a wellness visit in the past year, now is the time to schedule that visit. The annual wellness visit is a preventive wellness …

Category: Health Go Health

Information about Change Healthcare's Security Incident

WEBPayments for Horizon NJ Health and Horizon NJ TotalCare (HMO D-SNP) claims have been impacted by the recent Change Healthcare cyber security …

Category: Health Go Health

Change Healthcare Clarification

WEBChange Healthcare Clarification. We want to clarify a recent communication from Optum Health, which previously acquired Change Healthcare, related to an “Active …

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The medical information found on the MedUSafe website is designed to support, not to replace the relationship between patient and physician and the medical advice they may provide.