MedicaidAdministrativeHigh impact
Newsletter Vol. 13, No. 65
New Jersey Medicaid·NJ·Provider Notice
Effective date
Oct 16, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid (DMAHS) is implementing HIPAA-compliant electronic transaction standards for claims, encounters, and remittance advice. Providers must transition to HIPAA 837 format for claims by January 1, 2004, and remittance advice will shift to HIPAA 835 format by the same date. Paper claims remain permitted but electronic submitters must become HIPAA-compliant or risk claim processing delays.
Action Required
By October 16, 2003: Billing team must contact software vendor or billing agent to confirm HIPAA compliance status for New Jersey Medicaid claims submission. By January 1, 2004: All electronic claims must be submitted in HIPAA 837 format; proprietary formats will no longer be accepted (except for claims with dates of service prior to January 1, 2004, which have until October 16, 2004). By January 1, 2004: Remittance advice will transition to HIPAA 835 format; update EDI receiving processes. If not HIPAA-compliant by October 16, 2003, claims will continue processing in proprietary format only until January 1, 2004. Coordinate with billing software vendor or agent immediately—do not delay. Obtain free HIPAA certification testing through http://www.hipaadesk.com/?unisys to validate Level 7 compliance specific to DMAHS requirements (Level 6 minimum required).