HIPAA Testing Specific Requirements

HIPAA Testing Specific Requirements (New Jersey Medicaid)

HIPAA Testing Specific Requirements are offered by New Jersey Medicaid as stated in the NJ Medicaid HIPAA Companion Guides. Submitters wishing to test the NJ specific requirements must have an approved EDI Agreement on file with DXC Technology including a valid HIPAA Certification for the transaction type they wish to test. Test files must be submitted using the HIPAA Submitter Login link on the NJMMIS website at www.njmmis.com and may contain a maximum of 100 claims.

New Jersey Medicaid will require each prospective electronic data interchange (EDI) submitter to be certified and approved before HIPAA transactions will be processed in production. The Workgroup for Electronic Data Interchange (WEDI), through a collaborative healthcare industry effort called the Strategic National Implementation Process (SNIP), has recommended six types of transaction testing

Files containing more than 100 claims will be rejected. Summary and detail test result files in a semi-colon delimited format will be available for downloading from the download link on the “Upload or download HIPAA files” prompt on the website. In addition to the summary and detail reports, the 835 and 277P reports will also be available. The 835 will only be available to those submitters who are set up to receive the 835 transaction set. These files will be available after 09:00 a.m. Eastern Time the following morning the test files are sent.

To learn more about EDI and become a certified  EDI Professional please visit our course schedule page.

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