Newsletter Vol. 1, No. 05

Immediately: Billing team must update claim submission procedures for all HealthStart providers in New Jersey. (1) For Pediatric HealthStart services: Stop using any previous forms and require use of Report and Claim for EPSDT HealthStart Screening and Related Procedures (MC form) for all physician services, independent clinics, local health departments, and hospital outpatient departments. (2) Discontinue submission of form FD (Preventive Child Health Visit Record) when MC form is used. (3) For maternity services: Ensure all claims use Health Insurance Claim Form NJ for physician services, nurse midwifery services, independent clinics, and local health departments. (4) Implement 30-day claim submission deadline in billing system for all EPSDT and HealthStart services—claims submitted after 30 days from date of service will be denied. (5) Contact Unisys for EMC specifications and Fiscal Agent Billing Supplement guidance. Update provider education materials and billing templates. Failure to use correct forms and meet deadlines will result in claim denials.