To ensure members get the care they need, eliminate potential delays in admission and treatment, and help New Jersey hospitals deal with the increasing demand on staff resources, Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is waiving pre-authorization and pre-certification for inpatient admissions at in-network acute care hospitals. The change took effect on Mar. 27, and is in effect through April 30. It applies to every member and every plan type including Medicaid and Medicare. The company is also eliminating permanently the requirement for members covered by its Medicaid plans to obtain a referral from their primary care doctor for specialist care. No Horizon plans require PCP referral for specialist care.
“Horizon is doing everything we can to make sure our members get the care they need during the COVID-19 pandemic. We take seriously our partnership with New Jersey’s hospitals and are working closely together to make it easier for them to focus all of their resources on delivering critical and life-saving care,” said Allen Karp, Horizon BCBSNJ’s executive vice president for Health Care and Transformation. “New Jersey’s hospitals are under incredible stress right now. Hospital staff who traditionally handle administrative matters like pre-authorizations are being pulled in to support critical care delivery. Horizon is in regular contact with all of our hospital and health system colleagues and will continue to enable our front-line health care partners as they take care of our members and our communities.”
Effective immediately, Horizon BCBSNJ is:
Horizon BCBSNJ continues to monitor the COVID-19 pandemic and may extend these changes beyond April 30 as the situation dictates.
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