How to Submit Claims Electronically
You can electronically submit claims directly from your computer to us. This time-saving feature decreases your paperwork and reduces payment errors. Make sure you include the correct alpha prefix. If you are interested in obtaining more information on electronic claims submission options, call our office toll free at 1-888-EDI-9242.

Claims Processing Procedure
Once we receive your claims, we will electronically route them to the out-of-state BlueCross BlueShield Plan that will process the claim according to each member's contract. They will transmit the claim information to us, which will be included on your Provider Check Voucher. Please make sure that you are submitting the claims with the appropriate alpha prefixes.

What about utilization review?
Your BlueCross and BlueShield patients are responsible for obtaining precertification and preauthorization for services as defined by their contracts. You may choose to obtain that information. When doing so, please call 1-800-676-BLUE (2583).

Your Responsibilities
Since you participate with Horizon Blue Cross Blue Shield of New Jersey, the following responsibilities apply to you regardless of which BlueCross BlueShield Plan issues the ID card or services the member:

• Only collect the applicable copayment at the time of service.
• Submit the claim to Horizon BCBSNJ for processing.
• Only bill the patient for those amounts indicated on the summary statement as patient liability.
• Only bill the patient up to our applicable allowance for covered services.