Claims and Remittance Agreement Form Change for Multiple CPIDs
CollaborateMD Blog
The following payers have changed their claims and Remittance agreement forms:

CPID 1483 New Jersey Medicaid
CPID 5505 New Jersey Medicaid
CPID 5575 New Jersey Medicaid Inpatient
CPID 5576 New Jersey Medicaid Outpatient

Providers already approved to submit and receive transactions through the clearinghouse do not need to complete a new agreement form.

To access the new agreement form, please visit our website at, click Payer, and Payer Agreements Library.

Action Required: None for existing providers. New providers should begin using the new agreement form in the Payer Agreements Library immediately. Agreements with an October 2011 Version date will be denied.

If you have any questions, please contact Client Services at 1-888-348-8457, option 2.