Summary
New Jersey Medicaid has clarified the process for submitting good faith claims when providers are denied payment due to recipient ineligibility after verifying a valid MEI card. Providers can seek reimbursement for services rendered in good faith by submitting the claim with supporting documentation to a specific Paramax/Unisys address.
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What to do
Action · 2 steps
01When receiving Medicaid denials for recipient ineligibility (edit codes for 'Recipient Ineligible on Date(s) of Service' or 'Recipient Not on File') after verifying valid MEI card: Submit good faith claim with original MEI card or eligibility verification letter to Paramax/Unisys Provider Services Unit, CN 19, Trenton NJ, ATTN: Good Faith Claims.
02Verify all patient demographics and service dates are correct before submission as data entry errors do not qualify for good faith consideration.
Original notice
Newsletter Vol. 3, No. 01
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 3, No. 02MediumNo effective date · Medical PolicyNewsletter Vol. 3, No. 03LowNo effective date · Provider NoticeNewsletter Vol. 3, No. 04LowEffective Jan 1, 2025 · PharmacyNewsletter Vol. 3, No. 05MediumNo effective date · Provider NoticeBrowse every New Jersey Medicaid change in the policy list