Prescription Drug Listing

WebFor a pharmacy near you, visit our Provider Directory at horizonNJhealth.com or call Member Services toll free at 1-800-682-9090. People with hearing or speech difficulties …

Actived: 3 days ago

URL: Horizonnjhealth.com

Prescription Drug Listing

(8 days ago) Web(over-the-counter) drugs are covered at no cost, or low cost to you, as long as your doctor orders them and they are listed on our Formulary. A committee of doctors and …

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Medical Necessity Determination

(1 days ago) WebThe medical necessity determination process is made up of Drug Quantity Limits, Drug Utilization (Use) Review (DUR), and Prior Authorization/Approval (PA)/Medical Necessity …

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Covered Benefits

(2 days ago) WebIf you receive Managed Long Term Services & Supports (MLTSS) benefits, please view the MLTSS benefit chart. If you need additional information regarding a benefit please …

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Covered Services

(6 days ago) WebCovered Services - Horizon NJ Health Covered Services From doctor visits and dental care, to prescription drugs and more – Horizon NJ Health has you covered. No referrals! As a …

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Changes to covered medicines

(2 days ago) WebChanges to covered medicines Our Prescription Drug Listing, also called a formulary, is changing. The most up-to-date listing, including information about which drugs require …

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Pharmacy Medical Necessity Determination

(9 days ago) WebOur Pharmacy and Therapeutics (P&T) Committee is made up of physicians, pharmacists and Horizon NJ Health professionals. The committee establishes PA/MND criteria for …

Category:  Pharmacy,  Health Go Now

How to Submit Claims with Drug-Related (J or Q) Codes

(1 days ago) WebProfessional and institutional primary and secondary claims submitted with drug-related (J or Q) codes must include the National Drug Code (NDC) number, quantity and unit of …

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Modifier JW – Drug Waste

(7 days ago) WebWhen billed on a claim along with the amount of drug administered to the patient, Horizon NJ Health shall reimburse drug codes appropriately appended with modifier -JW for …

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Urine Drug Testing

(7 days ago) WebIndividualized urine drug testing should be ordered based on the member's specific needs. Therefore, generic standing orders or reflex testing will not be considered for …

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Reminder on the use of National Drug Codes (NDC)

(3 days ago) WebReminder on the use of National Drug Codes (NDC) All providers must comply with the NJ Medicaid NDC requirements. When billing for “J” and “Q” codes, the appropriate NDC …

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Change Healthcare Medical Injectable Drug Review to end

(4 days ago) WebWe previously announced that effective January 22, 2022, we would expand our collaboration with Change Healthcare (CHC) to review certain submitted claims for the …

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