![]() Claim is based on independent third party physician contract report. ¹ Claim based on NAIC Market Share Report, published 2023. The Braven Health℠ name and symbols are service marks of Braven Health. Up to 2,680/year for health products, including: Receive up to a 1,080 credit annually (270 per quarter) to spend on items from our over-the-counter (OTC) Benefit Catalog. Vision care, including exams, glasses and contact lenses. The Horizon® name and symbols are registered marks and OMNIA℠ is a service mark of Horizon Blue Cross Blue Shield of New Jersey. Dental care, including exams, X-rays, cleanings, fillings, crowns, periodontal care and dentures. The Blue Cross® and Blue Shield® name and symbols are registered marks of the Blue Cross Blue Shield Association. 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. 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. Hospital Services, inpatient and outpatient. Dental diagnostic and preventive services. If you do not enroll, you may not receive payment and could be terminated from our network. Compliance with this program is mandatory. As a participating provider, you will need to enroll with the New Jersey Medicaid 21st Century Cures Act program. ![]() To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. As a Horizon NJ Health member, you don’t need referrals for in-network specialists and have no or low copays for: Primary care office visits and preventive services. Last updated on: September 28, 2021, 01:25 AM ET. Cardiac focal ablation utilizing radiation therapy for arrhythmia noninvasive arrhythmia localization and mapping of. This website does not display all Qualified Health Plans available through Get Covered NJ. For services to be rendered on and after January 18, 2023, eviCore will also conduct pre-service MND review of the services represented by the CPT® Category III codes listed in the table below. Athena Diagnostics will bill the patient for any charges not paid by the insurance.įor plans that send payment directly to their members (including many BCBS plans), the patient may be required to submit a deposit of $100, however, the deposit is not required to move forward with testing.This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. We will file claims and appeals with a patient's insurance plan. The following insurance plans are in-network:Īthena Diagnostics accepts all commercial insurance plans, however, we do not have contracts with all commercial insurance plans. When possible, Athena Diagnostics will provide pre-authorization concierge support for the clinician and patient before the sample is drawn. Patients should check with their local provider for pre-authorization and coverage questions related to our services. In all instances, Athena Diagnostics will adhere to the terms of the patient’s individual policy insofar as payments for services are concerned. ![]() PHE Update: Prescription Limitation Change for Braven Health, HMO D-SNP and Medicare Section D parts. option 1 for Horizon Behavioral Health, Monday through Friday, 8 a.m. 1-80 1-80 (for NJ State Health Benefits Program only) Address for claims submitted via paper: Horizon BCBSNJ Horizon Behavioral Health PO Box 10191 Newark, NJ 07101-3189. For Providers: 1-80 Code Terminations as the PHE Ends. Register for Electronic Funds Transfer (EFT) via. REGISTER TODAY NAVINET SIGN IN REGISTER PRESENT. We will forward the appropriate notification of obligation to the patient as specified by the Explanation of Benefits (EOB). Reminder: Horizon NJ Health members are not responsible for PPE charges Call. We will bill insurance directly for all of our services with no up-front charges paid to Athena Diagnostics by the patient unless testing is not covered by the contracted payer. Patients with a commercial insurance plan for which Athena Diagnostics is a contracted provider are subject to the deductible, co-insurance or co-pay obligations of their plan. enable the IURO to obtain all medical records pertinent to the appeal, to: New Jersey Department of Banking and Insurance. Better access to care makes it easier for you to achieve your best health. ![]() Commercial Insurance In-Network Commercial Insurance
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