HIPAA 837 Attachment Cover Sheet Requirements (New Jersey Medicaid)
With the inception of HIPAA, there is a conscious effort to reduce the amount of paper required for claim submission. Previously, claims requiring additional information not provided on the hard copy claim forms or in electronic formats had to be submitted with attachments to provide the additional information needed to meet federally prescribed documentation regulations.
With the implementation of HIPAA electronic data interchanges in the 837 format these claims may now initially be submitted electronically with the required attachments following in the mail. Please keep the following items in mind when submitting attachments for HIPAA electronic data interchanges:
- The attachment cover sheet cannot be used as proof of timely filing;
- Attachments must be submitted within 45 days of the electronic claim submission;
- The original 15-digit ICN (Internal Control Number) as reported on the 277P Health Care Claim Pending Status Information transaction that is put on the attachment form must be “in process”;
- Please do not use the HIPAA Attachment Cover Sheet form located in this document. The form that is to be submitted can be retrieved through the “Forms & Documents” link found on the NJMMIS Website
- If the HIPAA Attachment Cover Sheet is not returned with the required attachment within 45 days the claim will deny.
Claims that require attachments and are submitted electronically will show as “Claims In Process” on the provider’s 277P Pend report. In addition, there will be two edits posted; edit 0464 – “HIPAA Claim Denied No Attachment” and the edit describing what attachment is needed. If the HIPAA Attachment Cover Sheet is not returned with the required attachment within 45 days, the claim will deny.
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