0000022825 00000 n Additionally, staying up-to-date with fee schedules can even attract new customers to your practice. You are leaving the Horizon Blue Cross Blue Shield of New Jersey website. 0000019706 00000 n Here are the instructions of how to enable JavaScript in your browser. Denplan Essentials helps you spread the cost of your regular preventive dental care and encourages you to keep your teeth in great condition to avoid any surprises. Register Now, Ancillary and Specialty Benefits for Employees. We currently don't offer resources in your area, but you can select an option below to see information for that state. 2023 Blue Cross and Blue Shield of North Carolina. Not a member? Log in or sign up. 0000045722 00000 n Please note:none of the following plans cover laboratory fees (to build crowns etc. Fee Schedule Request Form Enter your information below Required Fields Email Address Email Confirmation Requester Telephone # Requester Fax # Physician's Group Name Physician's Tax ID # Physician's NPI # Physician County Physician Specialty Product Managed Care PPO/Traditional Medicare Advantage All Comments This broad category includes anything from minor procedures like fillings to big interventions such as final restoration after root canal treatment, crown and tooth implants, and oral surgery. 0000015030 00000 n Notice on Third Party Solution Support. Dental benefit plans usually cover prevention in full and allow one or two procedures per year. Tolearn more, read more about. 0000021184 00000 n Providing patients with accurate pricing promotes transparency and trust and helps improve retention. 0000039046 00000 n Find out how to apply for a refund of your NHS dental charges on help with dental costs. Fee schedule prices may be lower than what you would charge otherwise. Please refresh the page and try again! This website does not display all Qualified Health Plans available through Get Covered NJ. Not a network dentist? 0000002902 00000 n 0000038657 00000 n The2021 Blue Cross Blue Shield FEP Dental Provider Implementation Guideis a resource for Federal Employee Program (FEP) dental providers that highlights important updates to the FEPBlueDentalprogram, new benefit information and claims submission tips to ensure smooth, accurate claims processing. 0000013256 00000 n Maintaining up-to-date fee schedules should be a priority in your practice. 0000004258 00000 n Find out what NHS dental treatment is available on NHS.UK. Insurers calculate schedule fees at their in-network rates. 0000009908 00000 n Dental Provider Resources Contact us at 1-855-504-2583, Dial 711 (for TTY relay services) for the names of participating providers or to request a zip code based provider directory. Choose your location to get started. The American Dental Association (ADA) has published a table with commonly reported CDT Codes with examples of possible ICD-10 diagnostic codes. 0000006002 00000 n 0000013693 00000 n Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. 0000043219 00000 n 0000015246 00000 n National Dental GRID/GRID+ network participation will not change your reimbursement or participating provider agreement in any way. All Rights Reserved. Varies. This is more true now than ever before, as a recent bill could offer Medicare recipients extended coverage for dental procedures considered medically necessary. 2023 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105. 0000053769 00000 n However, not all of their products may use the Dental GRID networks. Fee Schedules. These include prophylactic services that help prevent future issues, such as cleanings, fluoride treatments, and sealant application. BCBS FEP Dental members can utilize the GRID+ network as an in-network provider source. Diagnostic procedures include assessments and evaluations such as oral exams, X-rays, and 3D imaging. 0000042153 00000 n Coverage for some categories, such as crown installations, could be just 50%, while for others, it may reach 80% or even 100%. On the contrary, they can attract more patients to your dental practice. DenteMax is committed to delivering quality service and support to its dentists, client partners and their members. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Alternatively, youd have to send a follow-up bill to collect the remainder, which could hurt your brand and undermine trust. 0000018652 00000 n with examples of possible ICD-10 diagnostic codes. As a North Carolina provider, regardless of whether the patient is a Blue Cross NC . Our web portalpowered by Availitymakes doing business with Empire even easier. This update is for informational purposes only. 0000057435 00000 n There is no separate fee schedule for GRID or GRID+. ). Most people want to know upfront how much they need to pay you and how much their insurance plan will cover. Save 25% at specialists such as Endodontist, Orthodontist, Periodontists, Oral Surgeons and other specialists. hbbc`b``3} N- endstream endobj 148 0 obj <>/Metadata 17 0 R/Pages 16 0 R/StructTreeRoot 19 0 R/Type/Catalog/ViewerPreferences<>>> endobj 149 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 2621>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 150 0 obj <> endobj 151 0 obj <>stream For more than 20 years, we have been dedicated to delivering on our mission of improving the quality, cost effectiveness and accessibility of dental care for our customers. Inscribirse ahora! We also pride ourselves in providing outstanding service and support to our participating network dentists. The company oversees more than 20 dental networks in the United States and internationally. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. 0000001510 00000 n H\Pj0+tl{51akYpl%5,qC~S:@{1M5'Y+:S}#D%10)ri & _c}# g^iD?D &'dP (Co;k]'&-a If you estimate incorrectly because you havent updated your fee schedule, you risk under-collecting. Fee schedules set the prices for covered dental procedures based on the treatment categories they fall under. Here is everything you need to know about dental fee schedules, and if you are interested in improving your practices ability to manage dental insurance, see how Weave can simplify insurance verification. 0000056264 00000 n Customer Service: 1-800-432-3990In Topeka: 785-291-4180 Outside Area: 1-800-810-BLUE (2583) Nervous/Mental Health: 1-800-952-5906In Topeka: 785-233-1165GRID+ Dental: 1-800-432-3990 Inpatient care and nervous and mental health services may require prior authorization. To receive the most commonly billed procedure codes, fax a request on company letterhead to 410-872-4100 and include Provider ID, Tax ID, contact information and specific procedure codes if needed. Payment is not guaranteed. For claims issues, contact the company listed on the members ID card for questions related to a specific claim. Some services will require prior authorization. H\n@E^&%@"0vC,2fO_(# pU)~?9uMMpp$]5cu}rx:OwicxLS??KqnkS,e[>/34Cc!Vv[|]**E~&?Kr 7xKw 0000026292 00000 n February 10, 2021 Update: This communication has been updated with links to the 2021 Blue Cross Blue Shield FEP Dental Provider Implementation Guide and information about the GRID+ Dental Network. We offer a variety of dental payment plans to help you budget for your personal dental care. Health benefits are among the most effective ways to find and keep the best talent. For J.D. 0000008922 00000 n Dental plans created by dentists, to suit their patients' needs. For answers to our most commonly asked questions, please review: Dental Office FAQs Patients/Members FAQs Need something else? Dental plans created by dentists, to suit their patients needs. When you have a Blue Dental PPO plan, you have coverage from three networks of dental professionals: PPO in-network; . ~#G`srfkkkk `!=X Your Type 1 NPI is required for access. 0000020011 00000 n 147 43 0000039502 00000 n hbba`b``3 @ endstream endobj 252 0 obj <>/Metadata 16 0 R/Pages 15 0 R/StructTreeRoot 18 0 R/Type/Catalog/ViewerPreferences<>>> endobj 253 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 254 0 obj <> endobj 255 0 obj <> endobj 256 0 obj <> endobj 257 0 obj <> endobj 258 0 obj <>stream Members have received updated BCBS FEP Dental ID cards. Were still developing our website based on your feedback, so please tell us what you think. Get more: Something went wrong. 2021 Blue Cross Blue Shield FEP Dental Provider Implementation Guide: Important Updates, Tips and Benefit Information, Health Plans for Individuals and Families, Get a Quote for Individual and Family Plans, Non-Discrimination Policy and Accessibility Services, 2021 Blue Cross Blue Shield FEP Dental Provider Implementation Guide. We currently don't offer resources in your area, but you can select an option below to see information for that state. network and you'll be reimbursed based on the lower of your dentist's fees, or the maximum allowable charge, which is the amount that would be paid to dentists who have agreed to be reimbursed according to a negotiated fee schedule. The cost of your dental treatment depends on what treatment you need. Your dashboard may experience future loading problems if not resolved. The benefits of private dentistry with Denplan, Only in case of dental injury or emergency. 0000019271 00000 n 0000046360 00000 n 0000006823 00000 n , SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Valid NPI and Captcha are required to proceed. Learn more about our non-discrimination policy and no-cost services available to you. a resource to help you navigate the GRID program, Click here for an in-depth look at FEP BlueDental benefits, Surprise Billing - Out-Of-Network Provider Notice. 2023 Dental fee schedule. You can also visit bcbs.com to find resources for other states. To make doing business with us easier, we've developed a resource to help you navigate the GRID program. Information about dental costs and how to get help with paying for dental care. Get the support you need with Denplan. BlueDental Plus. The eDEN online application allows you to access and manipulate dental data and manage reports. 0000001196 00000 n BCBS FEP Dental is also available to retired uniformed service members and their eligible family members. Denplan patients, register for MyDenplan and access all your benefits. vu6tWqL(|d> SI9N39y'#)[r+93@,sRguM-^0_lo1}7: o+ endstream endobj 259 0 obj <> endobj 260 0 obj <> endobj 261 0 obj <> endobj 262 0 obj <>stream The list is far from exhaustive, and a complex treatment plan may require multiple diagnoses and more than one procedure code. Please contact your Network Services Representative toll free at 866-947-9398. 0000001436 00000 n However, working with insurers can increase your exposure and expand your client base, with the increased turnover making up for the lower fees. 0000004448 00000 n Learn more about our non-discrimination policy and no-cost services available to you. If the fee schedule allows for a maximum charge of $1,000, patients may pay anywhere between $0 and $500 out of pocket, depending on the treatment category. DeCare Dental Networks LLC, a subsidiary of DeCare Dental, develops and manages dentist networks for business partners locally, nationally and around the world. Necesita su ID de usuario? Proudly supporting more than 6,600 member dentists nationwide, and caring for around 1.4 million patients across the UK. The list is far from exhaustive, and a complex treatment plan may require multiple diagnoses and more than one procedure code. Empire BlueCross BlueShield providers access to networks of license dentist for insurance carriers,health maintenance organizations, employers, labor unions, trusts, third-party administrators, affiliated and nonaffiliated companies, or other groups of individuals which extend dental care benefits to employees, dependents, members, enrollees and participants eligible to receive such dental care benefits under the terms of the Plans. DENTAL FEE SCHEDULE Effective 01/01/2020 Print Date: 05/05/2020 Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) Pricing does not include cutbacks, assessment fees, etc. 2ypX y^Z#65O8tC;|{DH}*Kuwil\5!7A8&3QJ`'D Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Power 2022 award information, visit jdpower.com/awards. For more information on covered dental services or to register for the FEP Provider Portal, pleasevisitwww.bcbsfepdental.com. Fewer adjustments make for cleaner ledgers and statements, fewer mistakes, and faster payment processing. Help your clients offer their talent the best dental cover in the business: sell Denplan. Read more in the Communications section below. Afford the smile youve always wanted with the UKs leading dental plan provider. 6QQQQW((%%%%%#2"2"2".]]]]yWysP89o7o7o7KW/2K!cknne0i] atq_ 1d endstream endobj 263 0 obj <> endobj 264 0 obj <>stream frequently asked questions, 1-866-947-9398 (toll free) There are 3 NHS charge bands, the cost of each band is different in England and Wales. Read more about what happens when you visit an NHS dentist, personal dental treatment plans and missed appointments. Plan Feature. Find out how to get Denplan through your employer, and log in to your employee patient portal. This helps ensure accuracy and timely compensation. The benefits of private dentistry with Denplan. We currently don't offer resources in your area, but you can select an option below to see information for that state. 0000005524 00000 n 2023 PPO General Fee Schedule [pdf] 2023 PPO Specialist Fee . Find out who is entitled to free NHS dental treatment. Denplan Emergency offers you peace of mind in the event of a dental injury or dental emergency whether youre at home in the UK or abroad. Once you sign your in-network contract and become a participating provider, you must charge insured patients according to the insurers dental fee schedule. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. !bX>sN=o8/8{_bq b\Zq?}{/W7;. Denplan for Children is a simple way of keeping up the great habit of regular visits to the dentist for your child, without you worrying about unexpected bills. Insurers consider the following variables when setting UCR fees for services and treatments: You could charge above the UCR fee for a given procedure a tooth filling, for example but you may not go higher than the maximum allowable fee. Copyright YYYY Dental Network of America, LLC. Weave Payments is our all-in-one payment processing solution for dental offices, mental and behavioral health practices, and medical services. Most insurers classify dental treatment into three categories: As you can probably tell, coverage amounts decrease as dental problems get worse. If you already have one of our other plans, you can add Denplan Supplementary Insurance to your plan to give you similar cover. H\@E|E/g#lj,!K~H^8 m)>}D You will have to pay the NHS charge even if you normally qualify for free or reduced cost NHS dental services, but you may be able to claim a refund if either: Find out how to apply for a replacement appliance refund. FEPBlueDentalis now referred to as Blue Cross Blue Shield FEP Dental (BCBS FEP Dental). 0000015211 00000 n Discounts at the dentist. Most insurers use the so-called Usual, Customary, and Reasonable (UCR) fees to determine their rates. Designed to spread the cost of treatments, to make looking after dental health easy and affordable. www.bcbsfepdental.com Select a State Important Notice: Provider EFT EnrollmentsFederal Mandate & Other Enhancements Our EFT system is now available. If you need a replacement for a lost or broken NHS denture, bridge or orthodontic appliance, your dental practice will charge you. Important notice: Provider EFT Enrollments Federal Mandate and Other Enhancements, Dental Appointment Availability Standards, Third Party Administrators, Other Payors and our Affiliates, Augmented Intelligence Dental Claims Processing. 0000003870 00000 n BCBS FEP Dental is responsible for the selection of in-network providers in your area. By participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, you now have access to BCBS FEP Dental members. Choose your network below. For help using the Availity portal for dental providers, read our The national Dental GRID, administered by the GRID Dental Corporation (GDC), provides our members seamless access to in-network dental care, regardless of where they live or travel in the United States. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). National Dental GRID Participating Plans and Networks January 1, 2019 This participating Plans or affiliated networks for the national Dental GRID (PPO) or GRID+ (Traditional) networks shown below may have one or more products using the Dental GRID. 0000043412 00000 n read or download our informational brochure. Denplan Care. GRID Dental Corporation is a separate company that provides access to dental networks and services on behalf of Blue Cross NC. 0000007002 00000 n Some carriers now also cover certain. These amounts arent always the same: The insurer may have set a lower fee than your actual charge. We look forward to working with you to provide quality service for our members. 0000001691 00000 n 0000046083 00000 n 0000038634 00000 n Verify patient eligibility and benefits, view member history of completed procedures, and more. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. What treatment is clinically necessary for you is based on your dentists judgement. It looks like you're in . Important Notice: Provider EFT EnrollmentsFederal Mandate & Other Enhancements However, working with insurers can increase your exposure and expand your client base, with the increased turnover making up for the lower fees. 0000001772 00000 n The GRID networks are administered by GRID Dental Corporation for the exclusive use by Blue Cross and Blue Shield plan members nationwide. Insurers often promote participating dentist offices to their policyholders. If you have an EPO plan, it only covers care you get from PPO in-network dentists. You would be responsible for any amounts over the maximum charge aswell any co-insurance. If the plan cannot adequately answer questions about your contracted fee amount, please contact Blue Cross NCs Provider Service department at1-800-777-1643,Option 6. Weve brought together industry experts to share their best practices and pro tips for running a happy and efficient practice. 0000048184 00000 n We continue to monitor the ever-changing situation around COVID-19 and remain committed to helping dental professionals access the support & resources they need. DBA Anthem Blue Cross andBlue Shield, Anthem Health Plans of Virginia, Inc. DBA Anthem Blue Cross and Blue Shield, Anthem Health Plans, Inc. DBA Anthem Blue Cross and Blue Shield (CT), Anthem Insurance Companies, Inc. DBA Anthem Blue Cross and Blue Shield (IN), Blue Cross Blue Shield of Wisconsin DBA Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. DBA Anthem Blue Cross and BlueShield, Blue Cross of California DBA Anthem Blue Cross, Community Insurance Company DBA Anthem Blue Cross and Blue Shield (OH), CompcareHealthServicesInsuranceCorporationDBAAnthemBlueCross andBlueShield (WI), Empire HealthChoice Assurance, Inc. DBA Empire BlueCross BlueShield An Anthem Company or, Empire HealthChoice HMO, Inc. DBA Empire BlueCross BlueShield HMO or Empire BlueCross HMO (NY), Healthy Alliance Life Insurance Company DBA Anthem Blue Cross and Blue Shield (MO), HMO Missouri, Inc. DBA Anthem Blue Cross and Blue Shield, Matthew Thornton Health Plan, Inc. DBA Anthem Blue Cross and Blue Shield (NH), RightCHOICE Managed Care, Inc. DBA Anthem Blue Cross and Blue Shield (MO), RockyMountainHospitalandMedicalService,Inc.DBAAnthemBlueCross andBlueShield (COandNV), UniCareLife&HealthInsuranceCompanyDBAUniCareAnAnthemCompany. The 2023 Fee Schedules are effective January 1, 2023. Accessibility %PDF-1.4 % Please click Continue to leave this website. The platform packs in multiple options for contactless payment, enabling you to collect outstanding balances from patients. For more information about which plans your practice offers, speak to your Denplan dentist. Click here for an in-depth look at FEP BlueDental benefits. For members with Empiredental benefits and an affiliated medical plan, you can: Check the Communications section regularly for ongoing communications to our participating dental providers. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Dentists may also offer discounts on routine and restorative treatments as part of this plan. Usage Agreement One way to boost your income is to become an in-network provider and start billing patients per the insurers dental fee schedule. Or, if you would like to remain in the current site, click Cancel. 0000031918 00000 n There are 3 NHS charge bands, the cost of each band is different in England and Wales. This is more true now than ever before, as a recent bill could offer Medicare recipients extended coverage for dental procedures considered medically necessary. 0000015323 00000 n Recent enhancements and original features on Patient Health Record (previously called Patient Health History) can help your office become more efficient by delivering critical health information so you can better prepare for your patients. 0000005420 00000 n Training is free online and available at your convenience . The resources for our providers may differ between states. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. HWk\>?JC$&NhCezD]];w You currently have JavaScript disabled in your web browser, please enable JavaScript to view our website as intended. BCBS FEP Dental members have enhanced benefits as a result of a new partnership with. We hope you enjoy the content coming your way. What fee schedule applies? Coverage for some categories, such as crown installations, could be just 50%, while for others, it may reach 80% or even 100%. If your state isn't listed, check out bcbs.com to find coverage in your area. For help accessing an NHS dentist in an emergency or out of hours, visit: Your NHS dentist will provide any clinically necessary treatment needed to keep your mouth, teeth, and gums healthy and free of pain. Monday - Friday, 7 a.m. - 5 p.m. CST. 0000042599 00000 n UCR fees are standardized prices non-insured patients would pay for dental procedures in your area. 251 45 (Combined In-network/Out-of-network) In-network: $25/$75 Out-of-network: $50/$150. Often, fee schedule prices will be lower than your standard fees, but keep in mind that doesnt automatically translate into lower profits. Our Dental Provider Savings Program offers network providers discounts of up to 40% on in-demand products (PPE equipment, scanners), lab services (implants, clear aligners, dentures), and turnkey teledentistry solutions for your office. 0000339979 00000 n If the member is covered under the Federal Employee Health Benefit Program (FEHBP), you may need to file with the FEP medical ID card first. 1 At over 262,000 Providers/Locations 2 that welcome your Aetna Vital Savings card. Please see back of Member ID card for contact information. Your Denplan dentist will talk to you about your dental needs and tailor your individual plan to suit your personal oral health. 0000029107 00000 n Key Points Save an average of 10-60% on most dental services including dental savings on: cleanings, X-rays, root canals, crowns, dentures, implants, braces and more! The members card will be identified with BCBS FEP Dental at the top of the ID card, along with theclaimssubmission address and customer service number on the back to verify benefits. FEP Blue Dental Brochure - Blue Cross Blue Shield FEP Dental - Home Dental Networks DNoA contracts with quality dentists and group practices that accept our fee schedule as full payment when treating our members. Our EFT system is now available. Industry insights delivered straight to you. Please note that these forms are to be used by Federal Employee Program Members only, Important Update: Additional Policy Changes as PHE Ends, Referral Requirements for Services Not Related to COVID-19, Pre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions, Telemedicine Cost Share Waiver for Non-COVID-19-Related Services to End, Telemedicine Cost Share Waiver for Non-COVID-19-Related Services to End for Self-Insured Health Plans, Submitting Pharmacy Claims for COVID-19 Vaccinations, Reminder: Select one method for COVID-19 and Influenza Testing, Antibody testing: FDA and CDC do not recommend use to determine immunity, June 2021 Updates: COVID-19 treatment cost share waiver, Reminder: Use correct codes when evaluating for COVID-19, Submitting claims for COVID-19 vaccines delivered in non-traditional medical settings, For Essential Workers, COVID-19 Treatment Covered Under Workers Compensation Benefits, COVID-19 vaccine administration reimbursement at 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Illness (FUH), Follow-Up After High-Intensity Care for Substance Use Disorder (FUI), Follow-Up After Emergency Department Visit for Mental Illness (FUM), Initiation and Engagement of Substance Use Disorder Dependence Treatment (IET), Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA), Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD), Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia (SMC), Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD), HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results, Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA), Adults Access to Preventive/Ambulatory Health Services (AAP), Antibiotic Utilization for Respiratory Conditions (AXR), Appropriate Testing for Children with Pharyngitis (CWP), Appropriate Treatment for Upper Respiratory Infection (URI), Avoidance of Antibiotic Treatment for Acute Bronchitis/ Bronchiolitis (AAB), Blood Pressure Control for Patients With Diabetes (BPD), Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC), Child and Adolescent Well-Care Visits (WCV), Childhood Immunization Status (CIS) (CIS-E), Colorectal Cancer Screening (COL) (COL-E), Deprescribing of Benzodiazepines in Older Adults (DBO), Depression Remission or Response for Adolescents and Adults (DRR-E), Depression Screening and Follow-Up for Adolescents and Adults (DSF-E), Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD), Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD), Eye Exam for Patients With Diabetes (EED), Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA), Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC), Follow-Up After High- Intensity Care for Substance Use Disorder (FUI), Follow-Up Care for Children Prescribed ADHD Medication (ADD-E), Hemoglobin A1c Control for Patients With Diabetes (HBD), Immunizations for Adolescents (IMA) (IMA-E), Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET), Kidney Health Evaluation for Patients with Diabetes (KED), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E), Osteoporosis Management in Women Who Had a Fracture (OMW), Osteoporosis Screening in Older Women (OSW), Persistence of Beta- Blocker Treatment After a Heart Attack (PBH), Pharmacotherapy Management of COPD Exacerbation (PCE), Postpartum Depression Screening and Follow-Up (PDS-E), Prenatal Depression Screening and Follow-Up (PND-E), Statin Therapy for Patients with Cardiovascular Disease (SPC), Statin Therapy for Patients with Diabetes (SPD), Unhealthy Alcohol Use Screening and Follow-Up (ASF-E), Use of Imaging Studies for Low Back Pain (LBP), Use of Opioids from Multiple Providers (UOP), Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR), Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), Well-Child Visits in the First 30 Months of Life (W30), Policies, Procedures and General Guidelines, Programs Administered by eviCore healthcare, Participating Physician and Other Health Care Professional Office Manual, Behavioral Health Network Specialist Assignments, Eligibility and Benefits Cost Share Estimator, Womens Health Results and Recognition Program, Provider Guidelines: Non-Standard (Medical Record) Supplemental Data for HEDIS Gap Closure, How to Submit Supplemental Data to Horizon, Health Outcomes Survey: How You Can Drive Results, Radiation Therapy Medical Necessity Determination, Pregnancy-Newborn Episodes of Care Program: Helping to Improve Outcomes for Moms and Newborns, As Mental Health Needs Continue To Rise, So Do Innovative Virtual Services, Treat Knee, Back, and Hip Pain with Orthotic Device that Helps Avoid Invasive Procedures, Horizon Neighbors in Health Program Supports Struggling Families, Bariatric Surgery Value-Based Program Helps Members with Weight Loss, Dental Providers Benefit from Dedicated Horizon Liaisons, Connecting with parents on the importance of early childhood health screenings and vaccinations, Episodes of Care Program Gives Cancer Patients the Care They Need, HealthSphere gives a behavioral health provider the full patient view, Home-Delivered Meals Help Braven Health℠ Patients, Horizon Neighbors in Health Program Helps At-Risk Members in Camden, How a value-based primary care provider helps the New Jersey Vaccination Program, Improving Health Equity through Increased Access to Prenatal Care Across New Jersey, Making Pathways in Innovating and Advancing Maternal Health, Pharmacy Collaboration leads to better patient outcomes and cost savings, Providing Innovative Cancer Care - Expanding Episodes of Care, Telehealth after COVID-19 Many doctors agree it's here to stay, Value-based care -- transforming health care with better collaboration and improved health outcomes, When planning, collaboration and crisis merge - a medical practice's successful response to COVID-19, Applicable Products:Commercial PPO/EPO &Exchange POS/EPO, Applicable Products: Commercial HMO & POS, Claims Payment Policies and Other Information.