[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-288989-105":53,"doc-detail-288989-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","hmosystemsguide5010-new-jersey-medicaid-hipaa-5010","HMOSystemsGuide5010 - New Jersey Medicaid HIPAA 5010","","New Jersey Medicaid HIPAA 5010 implementation guide covering NCPDP 1.2 & D.0 transaction sets, versioned June 2026. Organizes documentation into loop/segment references, HIPAA X12 envelope and multiple claim and encounter workflows including 837 institutional, dental, professional, capitation (summary, detail, true-up), and capitated transportation encounters. Includes pharmacy transaction and reversals, 835 remittance advice, 834 managed care enrollment, 834 D-SNP enrollment, 820 premium payment, plus a data element dictionary with payer codes, admission priorities, patient status, and termination/disenrollment reason codes.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/hmosystemsguide5010-new-jersey-medicaid-hipaa-5010/288989/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/hmosystemsguide5010-new-jersey-medicaid-hipaa-5010/288989.png","ImageObject",442,249,{"name":88,"@type":89},"Cart","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-22","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":9},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What transactions does the guide cover for New Jersey Medicaid HIPAA 5010?","Question",{"text":108,"@type":109},"It covers HIPAA 837 encounter types (institutional, dental, professional, capitation, and capitated transportation), NCPDP pharmacy encounters and reversals, HIPAA 835 remittance advice, HIPAA 834 managed care and D-SNP enrollment, and HIPAA 820 premium payment.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Where can implementation details be found for transaction structures?",{"text":113,"@type":109},"Section 1 provides the loop/segment table, and Section 3 covers the HIPAA envelope; each transaction area is then organized into its corresponding section.",{"name":115,"@type":106,"acceptedAnswer":116},"What is included in the data element dictionary section?",{"text":117,"@type":109},"Section 17 includes code lists such as other payer codes, priority type of admission codes, patient status codes, transportation origin/destination codes, capitation and payment codes, and eligibility termination and disenrollment reason codes.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},288989,1790114838,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":141},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","New Jersey Medicaid  \nHIPAA 5010  \nNCPDP 1.2 & D.0 Transaction Sets  \nJune 2026  \nVERSION HISTORY ......................................................................................................................................................................................................................4  \nSECTION 1 – LOOP/SEGMENT TABLE ........................................................................................................................................................................................19  \nSECTION 2 – INTRODUCTION ....................................................................................................................................................................................................32  \nSECTION 3 – HIPAA ENVELOPE..................................................................................................................................................................................................33  \nSECTION 4 – HIPAA 837 INSTITUTIONAL ENCOUNTERS .............................................................................................................................................................35  \nSECTION 5 – HIPAA 837 DENTAL ENCOUNTERS .........................................................................................................................................................................66  \nSECTION 6 – HIPAA 837 PROFESSIONAL ENCOUNTERS..............................................................................................................................................................80  \nSECTION 7 – HIPAA 837 CAPITATION SUMMARY RECORDS.......................................................................................................................................................98  \nSECTION 8 – HIPAA 837 CAPITATION DETAIL RECORDS ...........................................................................................................................................................106  \nSECTION 9 – HIPAA 837 CAPITATION TRUE-UP RECORDS ........................................................................................................................................................117  \nSECTION 10 – HIPAA 837 CAPITATED TRANSPORTATION ENCOUNTERS ..................................................................................................................................125  \nSECTION 11 – NCPDP PHARMACY ENCOUNTERS.....................................................................................................................................................................141  \nSECTION 12 – NCPDP PHARMACY REVERSALS.........................................................................................................................................................................146  \nSECTION 13 – HIPAA 835 REMITTANCE ADVICE ......................................................................................................................................................................148  \nSECTION 14 – HIPAA 834 MANAGED CARE ENROLLMENT .......................................................................................................................................................156  \nSECTION 15 – HIPAA 834 D-SNP (DUAL ELIGIBLE SPECIAL NEEDS PLAN) ENROLLMENT ............................................................................................................ 162  \nSECTION 16 – HIPAA 820 PREMIUM PAYMENT .......................................................................................................................................................................165  \nSECTION 17 – DATA ELEMENT DICTIONARY ............................................................................................................................................................................167  \n17.1 – OTHER PAYER CODES .......................................................................................","cbCaiaRA94XKCa2t","https://ap.wps.com/l/cbCaiaRA94XKCa2t","pdf",7844160,202,"English","# VERSION HISTORY\n# SECTION 1 – LOOP/SEGMENT TABLE\n# SECTION 2 – INTRODUCTION\n# SECTION 3 – HIPAA ENVELOPE\n# SECTION 4 – HIPAA 837 INSTITUTIONAL ENCOUNTERS\n# SECTION 5 – HIPAA 837 DENTAL ENCOUNTERS\n# SECTION 6 – HIPAA 837 PROFESSIONAL ENCOUNTERS\n# SECTION 7 – HIPAA 837 CAPITATION SUMMARY RECORDS\n# SECTION 8 – HIPAA 837 CAPITATION DETAIL RECORDS\n# SECTION 9 – HIPAA 837 CAPITATION TRUE-UP RECORDS\n# SECTION 10 – HIPAA 837 CAPITATED TRANSPORTATION ENCOUNTERS\n# SECTION 11 – NCPDP PHARMACY ENCOUNTERS\n# SECTION 12 – NCPDP PHARMACY REVERSALS\n# SECTION 13 – HIPAA 835 REMITTANCE ADVICE\n# SECTION 14 – HIPAA 834 MANAGED CARE ENROLLMENT\n# SECTION 15 – HIPAA 834 D-SNP (DUAL ELIGIBLE SPECIAL NEEDS PLAN) ENROLLMENT\n# SECTION 16 – HIPAA 820 PREMIUM PAYMENT\n# SECTION 17 – DATA ELEMENT DICTIONARY","[{\"question\":\"What transactions does the guide cover for New Jersey Medicaid HIPAA 5010?\",\"answer\":\"It covers HIPAA 837 encounter types (institutional, dental, professional, capitation, and capitated transportation), NCPDP pharmacy encounters and reversals, HIPAA 835 remittance advice, HIPAA 834 managed care and D-SNP enrollment, and HIPAA 820 premium payment.\"},{\"question\":\"Where can implementation details be found for transaction structures?\",\"answer\":\"Section 1 provides the loop/segment table, and Section 3 covers the HIPAA envelope; each transaction area is then organized into its corresponding section.\"},{\"question\":\"What is included in the data element dictionary section?\",\"answer\":\"Section 17 includes code lists such as other payer codes, priority type of admission codes, patient status codes, transportation origin/destination codes, capitation and payment codes, and eligibility termination and disenrollment reason codes.\"}]","HMOSystemsGuide5010 - New Jersey Medicaid HIPAA 5010 | PDF",1789634347,71]