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Refer Members to our Preferred Labs
Act
immediately
Effective date
Not stated in the notice
Identified
Oct 3, 2026
Summary
Horizon BCBSNJ is mandating that participating providers refer patients with managed care plans lacking out-of-network benefits to Horizon's preferred labs (excluding LabCorp and Quest Diagnostics, or route samples through those vendors only). Non-compliance may result in network termination. Providers must verify patient plan type to determine lab referral requirements.
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What to do
immediately · 6 steps
01Providers and billing/front desk staff must implement lab referral protocols per patient plan type.
02Access the Horizon managed care plan list to identify which plans restrict out-of-network lab benefits.
03Update encounter workflows and EMR templates to flag when patients are enrolled in no-out-of-network plans and route lab orders to Horizon preferred labs only.
04Instruct providers to counsel patients at point-of-care about preferred lab requirements.
05For patients with LabCorp/Quest restrictions, ensure samples are sent through those vendors or Horizon preferred lab network only.
06Audit billing system to reject or flag lab orders sent to non-preferred facilities for restricted plans.
If missed: Failure to comply risks provider contract termination and network removal.
Original notice
Refer Members to our Preferred Labs
horizonblue.com · Always check the source before changing claims.
Related changes
See all Horizon BCBS NJ changes →Use Preferred LaboratoriesHighNo effective date · Provider NewsRefer Members to our Preferred LabsHighNo effective date · Provider NewsRemember to Use these Labs to Stay CompliantHighNo effective date · Provider NewsClinical Laboratory Out-of-Network Referral Chargeback for Managed Care PlansHighNo effective date · Medical PolicyBrowse every Horizon BCBS NJ change in the policy list