MedicaidAdministrativeHigh impact
Newsletter Vol. 6, No. 43
New Jersey Medicaid·NJ · Pharmacy·Prior Authorization
Effective date
Aug 1, 1996
We identified it
Jun 20, 2026
Summary
This policy establishes approved telecommunication systems (NDC, MediAmerica, Timeshare, Envoy) for New Jersey Medicaid pharmacy claims processing through a new Point-of-Sale/Prospective Drug Utilization Review (POS/PDUR) system. Pharmacies must transition to one of these approved systems or risk claim denials. Eligibility information availability through Blue Cross/Blue Shield of New Jersey will terminate on or about August 30, 1996.
Action Required
CRITICAL: By August 30, 1996, all pharmacy billing staff must: (1) Contact one of the four approved telecommunication systems (National Data Corporation, MediAmerica Incorporated, Timeshare, or Envoy) to enroll in the State-operated POS/PDUR claims processing system; (2) Configure billing software and systems to route all pharmacy claims (paper and electronic) through the selected approved switch; (3) Discontinue reliance on Blue Cross/Blue Shield of New Jersey for eligibility information retrieval, as this service terminates August 30, 1996. Pharmacies failing to participate in an approved system will experience unanticipated claim payment denials. Contact Unisys Provider Help Desk at (609) 588-6113 for technical support or Chief of Pharmaceutical Services at (609) 588-2724 for policy questions.