EDI Telecommunications Specifications (New Jersey Medicaid HIPAA Transactions)
EDI Submitters using the website will drop-off 837 transactions and pick-up TA1 and 999 transactions through a secure area of the New Jersey Medicaid Website.
HIPAA interchanges can be sent seven days a week, Sunday thru Saturday, with the following exceptions, which have been scheduled as maintenance windows – Thursday, 8 p.m. thru Friday 12 a.m. and Saturdays, 8 p.m. thru Sundays 4 a.m., Eastern time.
A valid submitter username and password is required before access is granted for drop-off and pick-up. New Jersey Medicaid and DXC Technology have deployed an Internet-based solution that will allow the electronic exchange of HIPAA transactions through the HIPAA Claims link on the NJMMIS Website.
Obtaining a Username and Password EDI Submitters will receive their Username and Password via the United States Postal Service mail upon verification of their HIPAA Certification for the specified HIPAA transaction sets. EDI Submitters will be registered on the submitter database via their EDI Submitter Agreement and certification documentation. Within 5 business days, your username and password will be sent to the Submitter information listed on the NJMMIS DXC Technology Submitter database, via the United States Postal Service mail.
After receiving your submitter username and password access the Website (www.njmmis.com) and select the HIPAA Claims link from the menu options on left side of screen. Enter your submitter username and password and click on Submit. Only files in the approved HIPAA formats may be uploaded.
You can upload up to five files at a time. All files being submitted must be of the same type as indicated in the file type selection area (i.e., up to five 837 – 005010X223A2 Institutional files can be submitted at one time. If you wish to also submit 837 – 005010X224A2 Dental files these must be sent after the previous file type has been submitted.
Users should allow 30 seconds or more before submitting additional files allowing for the TA1 to be created and returned to the user. The optimal file size recommendation for efficient file transfers, processing, and analysis by DXC Technology EDI staff is 5MB or less.
835 Claim Payment/Advice or 277P Claims Pending Status interchanges are available for downloading the following Wednesday after your file has been submitted as long as your submission is received and accepted for processing within the published submission deadlines.
HIPAA Claims Rejected Report files in a semi-colon delimited format are available for downloading the next morning following the nightly preprocessing of your file as long as your submission is received and accepted for processing. Click on the Recent Uploads link of the “View a list of Recent Uploads” prompt to pick-up TA1 and 999 Implementation Acknowledgements.
TA1 acknowledgements are displayed as text messages indicating Accepted; No Error or Rejected; indicating type of error detected. These are not available for downloading.
999 Implementation Acknowledgements are available for downloading no more than three hours after the TA1 acknowledgement has been received.
To learn more about EDI and become a certified EDI Professional please visit our course schedule page.