Horizon Blue Cross Blue Shield of New Jersey Prior Authorization

Coverage: Horizon professional provider manual guidance. Do not automatically apply these rules to Horizon NJ Health Medicaid, Braven, FEP, or every self-funded arrangement.

Start with the reviewed Horizon Blue Cross Blue Shield of New Jersey resources below. Confirm the member's current plan, the payer's operating status, and the requested service before scheduling care or submitting a request.

At a glance

• Use the authorization management tools in Availity Essentials and the applicable prior authorization search resources. Requirements depend on the service and member product.
• Verify the member product, network, and service before submitting.

Where to verify prior authorization requirements

• Verification resource 1
• Verification resource 2

How to submit prior authorization requests

• Authorization management tools in Availity Essentials

• No direct topic-specific link was captured in the current research set.

Information commonly required

• Not clearly published in the researched sources.

Turnaround notes and caveats

• Verify the member product, network, and service before submitting.

Provider resources

• Authorization guidance (official)
• Filing guidance (official)
• Claims guidance (official)

Sources

Update notes

Last updated: 2026-10-30.

• Added the official Horizon professional manual and Availity authorization tools. Retained the verified 180-day general filing rule and electronic payer ID 22099.
• Prompt-payment processing periods are not filing deadlines. Corrected-claim and product-specific exceptions remain unverified.