Avoid claim denials for New Jersey Medicaid
New Jersey 21st Century Cures Act requirement
Effective January 2023, UnitedHealthcare Community Plan of New Jersey began denying claims from any health care providers who are not compliant with the 21st Century Cures Act enrollment requirement.
How to be compliant
You must enroll as a fee-for-service or a 21st Century Cures Act health care provider on the New Jersey Medicaid Management Information System website. For us to process claims for payment, all National Provider Identifiers (NPIs) listed on the claim must be registered with the state.
Claim denial codes
If your claim is denied because you are not registered, you will see one of the following denial codes on your remittance advice:
| Denial code | Denial code description |
|---|---|
| QSA | Billing Provider validation issue |
| QSB | Billing Provider validation issue |
| QSC | Rendering Provider validation issue |
| QSD | Rendering Provider validation issue |
| QSE | Referring Provider validation issue |
| QSF | Referring Provider validation issue |
| QSV | Ordering Provider validation issue |
| QSW | Ordering Provider validation issue |
| QSX | Supervising Provider validation issue |
| QSY | Supervising Provider validation issue |
| QSG | Service Provider validation issue |
| QSH | Service Provider validation issue |
| QSJ | Attending Provider validation issue |
| QSK | Attending Provider validation issue |
| QSL | Operating Provider validation issue |
| QSM | Operating Provider validation issue |
| QSN | Other Provider validation issue |
| QSP | Other Provider validation issue |
You do not need to resubmit claims with these denial codes once you complete your enrollment. We will reprocess and adjust claims monthly for providers who are registered and listed on the state file.
Questions?
Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal Contact Us page. You can also contact UnitedHealthcare Provider Services at 888-362-3368, 8 a.m.–5 p.m. ET, Monday–Friday.
