Medical billing services in New Jersey
Billing, coding, credentialing and A/R follow-up for providers in New Jersey.
Billing in New Jersey: what is different
NJ FamilyCare managed care plans cover most Medicaid and CHIP members.
Key payers and contractors in New Jersey
- Medicare Part A/B
- Novitas Solutions, Jurisdiction JLPortal: Novitasphere
- Medicare DME
- Noridian, DME MAC Jurisdiction ADME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- NJ FamilyCarePortal: NJMMIS
- Blue Cross Blue Shield
- Horizon Blue Cross Blue Shield of New Jersey
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with New Jersey providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Novitas Solutions through Novitasphere
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in New Jersey: common questions
Do you bill NJ FamilyCare and its managed care plans?
Yes. We bill NJ FamilyCare fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in New Jersey?
Medicare Part A and B claims in New Jersey are processed by Novitas Solutions (Jurisdiction JL), and we submit and track them through Novitasphere. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction A), through the Noridian Medicare Portal (NMP).
Can you credential new providers in New Jersey?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in New Jersey.
Neighboring states and key payers
Get a free billing audit for your New Jersey practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.