When a physician or other health care professional joins Horizon Blue Cross Blue Shield of New Jersey’s network, he or she completes the Provider Application. We use the information from the Provider Application in our online provider directory. We verify this information every three years. If this information changes in between our checks, it is the provider’s responsibility to report the changes to us. You may always call the provider's office to confirm the information in our online provider directory.

Our directory lists the following:

• Name.
• Gender.
• Address.
• Degree: The type of education and training the professional completed.
• Medical specialty: The type of medicine the professional practices.

Board Certification

When a physician or other health care professional is board certified, it means that he or she has met the requirements of the American Board of Medical Specialties (ABMS), American Osteopathic Association, or another Horizon BCBSNJ-recognized board depending on the specialty. To become board certified, a physician must:

• Graduate from an accredited professional school.
• Complete specific training in a specialty.
• Practice in that specialty for a specified amount of time.
• Pass a written test.

Most boards require physicians to be periodically recertified. We check specialty board certification before a physician joins our network and at least every three years after that or more often according to state or federal requirements. If you would like more information about your physician’s board certification, visit the ABMS Web site at www.abms.org.

• Participating Hospital Affiliation: the network hospitals at which the provider has active or courtesy medical staff privileges. If you need hospital care, your physician may direct you to one of these hospitals.
• Languages: any language the physician or other health care professional speaks aside from English.
• Accepting New Patients: this information may change at any time.  We recommend contacting the provider’s office to confirm this is correct.
• ETIN: Electronic Transmitter Identification Number, also known as a Federal Tax Identification Number. This number identifies a business, such as a provider’s office.
• NPI: NPI stands for National Provider Identifier. This unique number identifies the individual health care provider.

Hospital Directory

The information below comes directly from the hospital or facility. We update this information at the hospital's or facility's request.

• Location.
• Facility name.
• Accreditation: identifies whether an external organization has reviewed the facility to assess the quality of its systems and processes. There are many accrediting organizations, each with its own set of criteria. The Joint Commission accredits all Horizon BCBSNJ facilities. For more information on accreditation, including accreditation status, visit The Joint Commission Web site at www.qualitycheck.org. 

BlueCard® PPO 

About BlueCard PPO...

The BlueCard^® PPO program is the premier national Blue Cross and/or Blue Shield Preferred Provider Program that links together more than 600,000 network doctors and 6,000 network hospitals in 48 states. This is a seamless network that affords members the ability to use any network doctor or network hospital in any location. So, for instance, a member that lives in Florida can use network providers in Georgia or any other state, just as if he or she was home. The network also includes hospitals and doctors abroad to make international travel more comforting.

No PCP or Referral Needed
With BlueCard PPO, members do not need to select a Primary Care Physician, and referrals are not needed to access specialty care. Members can access any network doctor or hospital at any time and enjoy the in-network level of benefits. Members can also use any doctor or hospital not in the network and receive an out-of-network level of coverage.

In- and Out-of-Network Benefits
In- and out-of-network levels of benefits vary depending on each member's group medical benefits. Typically, members enjoy a greater level of coverage when using BlueCard PPO network providers. Members should check with their employer or contact the Horizon BCBSNJ service line for additional information about their benefits.

Easy Service — No Hassles
When using BlueCard PPO doctors and hospitals, members have no claim forms to file and virtually no paperwork. All BlueCard PPO providers will handle all of the paperwork for them. Plus, Horizon BCBSNJ offers toll-free customer service Monday through Friday, 8 a.m. to 8 p.m., Eastern Standard Time, so members can get the help they need when it's convenient for them. Members also have access to our interactive Member Web site, where they can look up claim status and enjoy other online services designed to make their health care experience more satisfying.

How to Locate a BlueCard PPO Provider
Members can access BlueCard PPO network doctors and hospitals several ways. Using the functionality of this Web site, members can access information about network providers, including directions to their location. Click here to access the BlueCard Physician Finder. Members can also call the BlueCard Access Line at 1-800-810-BLUE (2583) to access PPO providers. If you are not yet an enrolled member, indicate that you are not yet enrolled but are considering becoming a member.

Portable Benefits Coverage
So, whether traveling (business or vacation) or living in another state (student away at college), members can take advantage of their benefits by presenting their Horizon BCBSNJ ID cards to any participating doctor or hospital. Once enrolled, members simply carry our easily identifiable ID cards with a PPO in a suitcase logo, which lists a toll-free number to help reach a BlueCard PPO provider.