If you need to obtain prior authorization for a Horizon member, you can submit your request via the Utilization Management Request Tool on Availity Essentials or call 1-800-664-BLUE (2583).

CORRECTED CLAIMS AND INQUIRIES ITS and Fund Accounts must submit corrected claims using Form 579, Inquiry Request and Adjustment Form. For corrected claims processed by eviCore healthcare for radiology services, use Form 579 to add multiple bill lines not included in the original claim submission.

Call Member Services toll free at 1-800-682-9090 (TTY/TDD 711). They will give you instructions on what to do.

We must receive all claims within 180 calendar days from the initial date of services. If claims are not received within 180 calendar days from the initial date of service, claims will be denied for untimely filing.

Claims and Appeals‌ 1-800-682-9094, ext. 9606, prompt 2. For questions regarding billing or appeals, please contact the Physician and Health Care Hotline at 1-800-682-9091 and/or your Professional Relations Representative.

If you are enrolled in a fully insured health plan1, Form 1095-B gives you information about your Horizon health insurance coverage to help you properly prepare your tax return.

Background. Prior authorization helps Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers ensure that applicable Medicare coverage, payment, and coding rules are met before DMEPOS items are delivered.