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Horizon BCBS NJMedicare Advantage · Administrative · Provider News · NJ · General Practice, Internal Medicine, Family Medicine +17 moreHigh impact

Recredentialing Required for Most Hospital-Based Practitioners

Act
immediately
Effective date
Not stated in the notice
Identified
Oct 3, 2026

Summary

Horizon and Horizon NJ Health now require recredentialing every three years for most hospital-based physicians and healthcare professionals (excluding Radiologists, Anesthesiologists, Pathologists, and Emergency Room Physicians). Failure to complete recredentialing by the required deadline will result in loss or restriction of network participation and termination of provider agreements.

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What to do

immediately · 4 steps
01Billing team must identify all hospital-based providers in network (excluding Radiologists, Anesthesiologists, Pathologists, and ER Physicians) and determine their recredentialing expiration dates.
02Providers must complete recredentialing through CAQH ProView (preferred) or the New Jersey Universal Recredentialing Application Form before their three-year cycle expires.
03Coordinate with Andros (the credentialing business partner) when contacted.
04Flag any providers approaching recredentialing deadlines to ensure timely completion.
If missed: Failure to recredential within the required timeframe will result in provider network termination and claims denial from that practitioner.

Original notice

Recredentialing Required for Most Hospital-Based Practitioners
horizonblue.com · Always check the source before changing claims.
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