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Medicare New Jersey Part B

Part of Novitas Solutions, Inc.

Government programdentalmedical
Typical enrollment turnaround
45-65 days

Summary

Medicare New Jersey Part B is a government program, administered by Novitas Solutions, Inc., offering dental and medical coverage operating in 12 states. Claims route under payer ID 12402, with 3 alternate IDs in use across clearinghouses. Provider enrollment typically takes 45-65 days, with applications through Novitas Solutions Portal, and CAQH is not used. Through clearinghouses it supports eligibility checks, professional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID
12402Also seen as 1465, NJMCR, SMNJ0
Also known as
Novitas - New Jersey
Uses CAQH
NoApplication route: Payer's own application
Service area
JH: AZ, CO, LA, MS, NM, OK, TX | JL: DC, DE, MD, NJ, PA

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

TransactionEnrollmentTypical setup
Eligibility checks (270/271)RequiredSame day
Professional claims (837P)RequiredSeveral weeks
ERA / remittance (835)RequiredSeveral weeks

Common questions

What is the payer ID for Medicare New Jersey Part B?
The payer ID for Medicare New Jersey Part B is 12402. Alternate IDs seen across clearinghouses include 1465, NJMCR, SMNJ0.
How long does Medicare New Jersey Part B provider enrollment take?
Medicare New Jersey Part B provider enrollment typically takes 45-65 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
Does Medicare New Jersey Part B require CAQH?
No. Medicare New Jersey Part B does not use CAQH. Applications go through its own enrollment process.
Does Medicare New Jersey Part B require ERA enrollment?
Yes. Medicare New Jersey Part B requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
What states does Medicare New Jersey Part B cover?
Medicare New Jersey Part B operates in JH: AZ, CO, LA, MS, NM, OK, TX | JL: DC, DE, MD, NJ, PA. Coverage can differ by plan and product line, so confirm the specific plan before you file.

Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.