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Claim Dispute Submission Changes Effective June 1, 2026
Act
by May 31, 2026
Effective date
Jun 1, 2026
Identified
Oct 3, 2026
Summary
Effective June 1, 2026, Horizon Blue Cross Blue Shield will no longer accept claim disputes submitted by phone for Horizon NJ Health (Medicaid) and Federal Employee Program (FEP) members. All claim disputes must be submitted through the Provider Portal (Availity Essentials). Claim appeals remain unchanged and must continue to be submitted in writing.
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What to do
by May 31, 2026 · 6 steps
01Billing team must cease all phone-based claim dispute submissions for Horizon NJ Health (Medicaid) and FEP members.
02Train all staff on the new portal-based dispute submission process using Availity Essentials.
03Update internal billing workflows and communication templates to direct disputes to the Provider Portal.
04Document the step-by-step process (sign in to Availity, navigate to Claims & Payments, select Claim Status, message payer with detailed dispute description).
05Verify all billing staff can successfully access and navigate Availity Essentials before the effective date.
06Note: Claim appeals (separate from disputes) continue to require written submission only and are not affected by this change.
If missed: Failure to use the portal will result in claim disputes being rejected.
Original notice
Claim Dispute Submission Changes Effective June 1, 2026
horizonblue.com · Always check the source before changing claims.