New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 53A - HOSPICE SERVICES MANUAL
Subchapter 4 - BASIS OF PAYMENT
Section 10:53A-4.5 - Submitting claims for payment

(a) The hospice shall submit claims in accordance with policies and procedures set forth in 10:49-7.1, 7.2 and 7.3, incorporated herein by reference, regarding the timely filing of claims and the timeliness of claims submission and inquiry.

(b) Documents needed specifically for the administration of the Hospice Care Program are Forms #1 through #10 located in the Appendix at the end of this chapter and may be obtained by writing to the following address:

Molina Medicaid Solutions

Provider Enrollment

PO Box 4804

Trenton, New Jersey 08650-4804

or forms can be downloaded from Molina's website at: http://www.njmmis.com.