HEN

BCBS Prefix HEN

Horizon Blue Cross and Blue Shield of New Jersey

New Jersey • Traditional Indemnity, EPO, HMO

Billing essentials

Provider phone
1-800-624-1110
Electronic payer ID
22099
Claims mailing address
P.O. Box 820, Newark, NJ 07101
Timely filing limit
365 daysCompare all plans
Prior authorization phone
(201) 355-9800

Coverage under prefix HEN

Traditional Indemnity

Traditional indemnity coverage means the member has fee-for-service insurance with no network limitations. Any licensed provider can be seen without referrals. Claims are reimbursed based on usual, customary, and reasonable (UCR) charges. The member typically pays a deductible and a percentage of allowed charges.

EPO

EPO coverage under this prefix means the member must use network providers but does not need referrals for specialist visits. This plan type is becoming more common as it offers lower premiums than PPO plans while providing more flexibility than HMOs. Verify network status before providing services.

HMO

HMO coverage means this member must use providers within the plan's network. A primary care physician serves as the care coordinator and must authorize specialist referrals. Emergency services are the primary exception to the network requirement. Always verify referral status before providing non-emergency specialty care.

About Horizon Blue Cross and Blue Shield of New Jersey

Largest health insurer in New Jersey serving over 3.8 million members with commercial, Medicare and Medicaid plans.