Horizon BCBS of New Jersey virtual national network

Updated

The Horizon (Blue Cross Blue Shield of New Jersey) virtual network allows providers outside of New Jersey to see Horizon clients who reside within the state they are credentialed with through Headway. These clients can only be seen virtually.

This means that Horizon's out-of-state clients have more options when booking with providers, and providers can expand their reach to new clients.

An important note on eligibility

You cannot live in and/or be credentialed in New Jersey and some counties in New York (Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, and Westchester Counties) to join this virtual network.

Your client cannot live in New Jersey or some counties in New York (Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, and Westchester Counties) to be seen through the BCBS Horizon NJ virtual network. 

How it works

As a provider in the virtual network, you are not officially credentialed with Horizon BCBS NJ. Still, you can see clients with Horizon insurance via telehealth within the state you practice in on Headway.

To hold in-person sessions with Horizon clients, please ensure you are credentialed with your local state’s BCBS affiliate and the client has BlueCard benefits with their Horizon insurance. You can review the carriers you’re credentialed with on your Insurance Status page.

 

Eligibility

Here’s who is eligible to join the Horizon Blue Cross Blue Shield of New Jersey virtual network:

  • Providers who are live with a Headway state and credentialed with at least one carrier
  • Providers who practice on Headway virtually
  • Providers whose state of residence and the state they practice in on Headway match
    • i.e. State of residence is Pennsylvania and practicing on Headway in Pennsylvania
  • Providers who are not already credentialed with Headway in New Jersey and the following counties in New York: Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, and Westchester Counties

Some examples

✅ If you are an LMFT provider credentialed in Pennsylvania and fully credentialed with Aetna, practicing virtually and in-person, you can join the Horizon BCBS NJ virtual network

✅ If you are an LMFT provider credentialed in Pennsylvania and fully credentialed with Cigna, practicing virtually and in-person, you can see clients with Horizon BCBS NJ insurance who live in Pennsylvania

❌ If you are an LMFT provider credentialed in New Jersey (or the New York counties mentioned above) and fully credentialed with Cigna, practicing virtually and in-person, you CANNOT join the Horizon BCBS NJ virtual network. This is because you are credentialed in New Jersey already. 

❌ If you are an LMFT provider credentialed in Pennsylvania and fully credentialed with Cigna, practicing virtually and in-person, you cannot see a Horizon BCBS NJ client located in New Jersey. This is because the client must be located in the same state you are practicing in (in this case, Pennsylvania). 


Rates 

You can view the rates for Horizon Blue Cross Blue Shield of New Jersey virtual sessions on your rates and agreements page.

 

Holding in-person sessions with these clients

To see a Horizon BCBS NJ client in person, you must be credentialed with the local Blue Cross affiliate, and the client has BlueCard benefits with their Horizon Insurance.

For example, a provider in Georgia must be credentialed Anthem BCBS Georgia in order to see Horizon clients for in-person sessions.

 

Joining the virtual network

All eligible providers will receive communications in early 2024 asking if they’d like to participate, if a provider doesn’t wish to participate they will have the option to opt out of the network. All eligible providers will see the Horizon BCBS NJ virtual network reflected on their Insurance Status page.

 

Opting out of the virtual network

If you do not wish to participate in the Horizon BCBS NJ virtual network, you can opt out at any time by visiting your Insurance Status page  and clicking the “Opt out” button.

 

FAQs

How do I know if I have a client with Horizon Blue Cross Blue Shield of New Jersey insurance?

You can view what specific insurance your client has by visiting your client roster.

What if I am already credentialed with my state’s local Blue plan?
If you're already credentialed with your state's local Blue plan, you're still eligible to join the Horizon BCBS virtual network. In these cases, the virtual appointments you have will be paid under Horizon BCBS virtual rates. In-person sessions will be paid out under the local Blue plan rates. You can view the rates for Horizon Blue Cross Blue Shield of New Jersey virtual sessions on your rates and agreements page.

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