Patient Health Support
These programs help support the care you provide to your patients. More information about all of these programs is available.
CASE MANAGEMENT PROGRAM
The Case Management Program is designed to help our members get the care and services they need. Our specially trained care managers are registered nurses who work with our members and your office or facility staff to help members understand their health care options and coordinate their health care services.
Access the Case Management Form, or visit our Patient Health Support page for more information.
Case Management Program Eligibility
Members who have serious or complex medical conditions, which may be long-term, catastrophic or terminal, are eligible for case management.
Providers refer most participants enrolled in the program; however, members or their caregivers may also request case management services. Discharge planners may make a referral to Case Management; others are asked to participate based on review of claims data and/or their use of services.
Care managers continue to work with members – and your office or facility – for as long as the member is enrolled and meets our case management criteria.
Click here more information about Horizon Case Management Programs or call 1-888-621-5894, option 2.
CHRONIC CARE PROGRAM
The right preventive care and early detection of disease are critical to healthy living. Horizon BCBSNJ offers the Chronic Care Program to eligible members who have been diagnosed with one of the chronic conditions listed below:
- Chronic Obstructive Pulmonary Disease (COPD)
- Coronary Artery Disease (CAD)
- Heart Failure
You can enroll eligible members using our referral form.
To receive information on the programs, call 1-888-333-9617.
Not all programs may be available for all products or lines of business.
PRECIOUS ADDITIONS® PROGRAM
The PRECIOUS ADDITIONS program is a free, mail only, voluntary educational resource that provides members with valuable health information on their pregnancies.
To receive the most benefit from this program, eligible Horizon members must enroll in PRECIOUS ADDITIONS early in the first trimester.
HIGH-RISK MATERNITY PROGRAM
Your patients who are identified as high risk may be eligible to enroll in our Complex Case Management's High-Risk Maternity Program.
Through this program, nurse care specialists address members' concerns about their pregnancy and assist them in making informed decisions regarding facility and care options.
Your patients may call 1-888-621-5894, option 2, to learn more about the High-Risk Maternity Program.
24/7 NURSE LINE
Most Horizon members are eligible to take advantage of the 24/7 Nurse Line.
Members can speak to experienced registered nurses who are specially trained to offer prompt general health information. Health care resources are available 24 hours a day, seven days a week, at no cost to them. The phone number for the 24/7 Nurse Line is displayed on each eligible member's ID card.
24/7 Nurse Line Chat
Our 24/7 Nurse Line also offers members access to a chat feature where members can interact online in real-time with a health care resource about various health and wellness issues.
The 24/7 Nurse Line is for informational purposes only. Nurses cannot diagnose problems or recommend specific treatment. They are not a substitute for a physician's care. Nurse Line services are not an emergency or urgent care service and may be discontinued at any time. In the event of an emergency, members should call 911 or the local emergency number and/or their doctor.
Availability of certain programs may require additional purchase by employer groups.