Horizon NJ Health: What Reviewers Wish Agencies Knew About PDN Documentation

Every PDN authorization request tells a story. 

This session takes agencies inside the review process to explain what clinical reviewers are actually looking for, where documentation most often falls short, and how those gaps show up later in denials and fair hearings. 

Presented by a Horizon utilization management leader and physician reviewer, this practical session covers the documentation elements that support medical necessity, common pitfalls in pediatric and adult PDN requests, and how strong documentation supports better outcomes for members and agencies alike. 

Attendees will leave with concrete steps to strengthen their submissions and reduce avoidable denials.