MedicaidAdministrativeMedium impact
Newsletter Vol. 13, No. 10
New Jersey Medicaid·NJ·Medical Policy
Effective date
Mar 1, 2003
We identified it
Jun 20, 2026
Summary
Effective March 1, 2003, NJ FamilyCare is restructuring parent/caretaker coverage by transitioning certain Plan A beneficiaries to Plan D (managed care) or the new Plan I (fee-for-service). Plan D and Plan I offer identical benefits; the difference is delivery method. Co-payment requirements vary by plan and will be indicated on identification cards. Billing teams must verify plan designation and co-payment obligations on each patient's NJ FamilyCare or HMO card at the time of service.
Action Required
By February 28, 2003: (1) Billing and front desk staff must be trained to verify Plan D vs. Plan I designation on every NJ FamilyCare patient's identification card and HMO card. (2) Establish a process to check patient cards for co-payment indicators before service delivery or at point of care. (3) Update internal documentation to clarify that Plan D is managed care (HMO-delivered) and Plan I is fee-for-service, with identical benefit coverage. (4) Train staff to contact REVS (1-800-676-6562) or their MEVS vendor to verify eligibility and service package designation when card information is unclear. (5) Note that children and parents/caretakers may have different plans—verify each individually. Failure to correctly identify plan type and co-payment obligations may result in incorrect billing, patient collections errors, or claim denials.