Health Care Vendors - Horizon NJ Health (2024)

Vision Services
Davis Vision administers vision care benefits for members. Benefits include exams, eyeglasses, corrective lenses and contact lenses.

• Members may self-refer.
• Benefit is for one routine eye exam each year.
• If a condition that requires additional care is detected during the annual exam, the PCP must be contacted.
• Participating providers are listed in the online provider directory. Davis Vision: 1-800-933-9371

Dental Services
SKYGEN USA administers dental benefits for Horizon NJ Health members.

• A full range of preventive and diagnostic services are available to certain members.
• Members may self-refer.
• Participating providers are listed in the online provider directory.
• SKYGEN USA Provider Services: 1-855-878-5368.

Laboratory Services
Laboratory Corporation of America (LabCorp) is our exclusive laboratory services provider.

• A LabCorp requisition form is required.

• Always include a valid diagnosis code on the lab requisition/lab scripts.

  See Also

  Covered Drugs - Horizon NJ HealthDoes Medicaid Check Your Bank AccountNew Jersey FamilyCare (NJFC) | Benefits.govDivision of Aging Services

• Providers must notify members by telephone of laboratory and radiology results within 24 hours of receipt in urgent or emergent cases or by appointment when necessary.

• Rapid strep test results must be given to the member within 24 hours of the test.

• Providers may use a participating hospital for STAT labs and pre-admission testing.

  • Providers must follow the hospital’s STAT/PAT procedures.

  • A referral is required.

• If a procedure is not on the STAT/PAT list (in Section 3.18 of the Provider Administrative Manual), providers must call our Utilization Management department for authorization.

  See Also

  Horizon Blue Cross Blue Shield NJ Expands Bariatric Surgery Coverage

• LabCorp locations are listed in the provider directory.

• LabCorp: 1-800-631-5250

Pharmacy Services
Horizon NJ Health manages its own pharmacy benefit for members.

• We have a formulary and require providers to prescribe generic medications, when possible.

• NJ FamilyCare C and D members have a copay.

• Many over-the-counter drugs are covered when ordered with a prescription.

• We reserve the right to require members to use specific pharmacies in certain situations.

• Preauthorization is required for multi-source brand-name drugs and non-formulary drugs. Refer to our formulary guide or our Pharmacy Department for preauthorization requirements.

• Horizon NJ Health Pharmacy Department: 1-800-682-9094