Medicaid New Jersey providers wishing to receive their remittance advice information electronically must complete the Submitter Electronic Remittance EDI Agreement (Form EDI –801).
Select: MEDICAIDMedia Preference: WebSubmitter Name: Availity LLCSubmitter ID: 9904719Address: 10752 Deerwood Park Blvd, Suite 110Jacksonville, Florida 32256
Website: https://www.njmmis.com/default.aspxUnder Information, select "Forms and Documents"Select "Submit Request"Download: EDI-801 Electronic Remittance Agreement.
610515_MEDICAID NEW JERSEY_835.062022.pdf