What products require prior authorization?
As of January 1, 2005, a prior authorization is required for NJ PLUS members for the referenced AIS procedures. Also included will be insured Horizon POS, Horizon PPO and Horizon Direct Access plans. Horizon Medicare Blue, Horizon Medicare Blue Plus and Horizon Medicare Blue Value will be effective as of April 1, 2005. Please note: Prior Authorization does not apply to radiology/imaging services rendered during Emergency Room visits, Observation Unit or inpatient stays. Prior authorization is not required for Small Group (Reform) and Individual products.
