MedicaidReimbursementHigh impact
Newsletter Vol. 2, No. 02
New Jersey Medicaid·NJ·Reimbursement
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Due to startup problems with the new Medicaid Management Information System (MMIS), the Division is issuing temporary payment advances to providers in January to ensure adequate cash flow. Providers will receive interim payments (either two weeks or one week of average payment level depending on specialty), which will be recaptured through reduced claims payments starting in February over several months. All providers must strictly adhere to new billing procedures to avoid processing delays.
Action Required
REQUIREMENTS:
- Immediately: All billing staff must review and strictly adhere to all new MMIS billing procedures outlined in the Division guidelines. Non-compliance will result in delayed claims processing.
- January 2024: Expect and account for temporary payment advances on remittance advice. These advances will appear as financial transactions alongside regular claims payments from Unisys.
- Beginning February 2024: Billing staff must account for payment recaptures starting at an unspecified percentage of approved payments, with withholding levels increasing cumulatively through February. Adjust cash flow projections and accounts receivable reconciliation accordingly.
- Ongoing through repayment: Continue monitoring remittance advice for recapture withholdings until all advance amounts are fully repaid (typically 4+ weeks after advance issuance).
- Immediately: For any billing questions or claims processing issues, contact Unisys Provider Services in writing at the CN address provided or use the improved telephone system. Document all inquiries for follow-up.
- Providers of medical supplies and equipment: Expect a different payment advance schedule (one week vs. two weeks for other providers) and plan cash flow accordingly.