Horizon Requires Participating Providers to Use Availity Essentials in 2027
11/05/2026
Horizon NJ Health announced a new provider portal policy effective January 1, 2027, requiring participating providers to use Availity Essentials for applicable transactions and communications. Listed functions include eligibility and benefits verification, pre-service cost-share checks, claim submission and status review, access to explanations of payment, authorization requests and status checks, and practice-related provider-profile updates.
Practices should identify which staff and vendors perform these transactions and make sure the organization has an Availity registration and administrator who can create user accounts. The notice specifically asks providers to share the information with staff, clearinghouses and vendors as appropriate. Before the effective date, test access and review which transactions are covered by the requirement. The notice does not say every interaction with Horizon must move to Availity; it applies to the transactions and communications covered by the policy. Retain the payer’s instructions for any exceptions or workflows that remain elsewhere.
Why it matters
A required portal change affects daily functions such as eligibility checks, authorization work and other provider transactions, so it needs operational preparation rather than a last-minute bookmark change. The policy is scheduled for January 1, 2027; practices should confirm which tools and participating-provider activities are included in Horizon’s notice before retiring existing processes.
What practices should do
Review Horizon’s notice to identify the transactions covered by the portal requirement, then confirm Availity registration and permissions for every staff role that uses those functions. Test the relevant workflows before January 1, 2027, update written procedures and remove obsolete steps only after testing. Keep a named contact for access problems and retain proof of any portal submission.