New Jersey Medicaid

Please follow the Enrollment Instructions below to become an electronic submitter for New Jersey Medicaid.

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed and returned to the NJ Medicaid office prior to initiation of electronic claims submission or inquiry.

1. EDI 101 New Submitter Agreement
2. EDI 201 Submitter Provider Agreement
3. EDI 801 Electronic Remittance Agreement

If the links listed above do not work properly, you can download the forms from here:

The first drop down, Select “Provider”
The second drop down Select “HIPAA”
Press “Submit”

If you have any questions regarding the documents and process listed please call the NJ Medicaid EDI Support Center at: 609-588-6051

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

Our Vendor Information

Vendor Name - AXIOM Systems, Inc.
Contact - EDI Team
Vendor Code - 9802070
Phone - 602-439-2525
Fax - 602-439-0808
Address - 241 East 4th Street, Suite 200
Frederick, MD 21701
Software Name - SolAce EMC
E-mail -

Please Note: If you are using a Billing Service, your Billing Service is the “Submitter” and you will only put your information in the Provider Sections. Since your Billing Service is the one submitting and receiving on your behalf, please have them fill in the Sections for Submitter with their information.

EDI 101 New Submitter Agreement


  • Check the box for “Medicaid”

Section 1:

  • Enter the name of the Submitter, whether it be provider, clearinghouse, or billing service
  • Enter the demographic and contact information of the submitter
  • Enter the contact information for the main contact
  • The Submitter Representative’s signature should be the person who has liability authority of the business
  • Print name and Date the application

Section 2:

  • Check the box in the 5010 section for 837 Claim Professional
  • For Certification Vendor Name enter: AXIOM Systems, Inc. formerly Ivertex
  • Check the box for “No”

Section 3:

  • Software Vendor Name: AXIOM Systems Inc. formerly Ivertex
  • Enter the address and contact information listed in the box above
  • Product Name SolAce EMC
  • Version is 4.0.11
  • Release date: Sep 18th 2012

EDI 201 Submitter Provider Agreement

Header: Check Medicaid

Section 1:

  • Enter the name of the Submitter, whether it be the provider, clearinghouse or billing service
    • If you are a provider applying for a New Submitter ID, leave the Submitter ID blank
    • If you are a Billing Service who already has an ID, enter your Submitter ID
  • Enter the Name, Address, and Contact information for the Submitter’s Authorized Representative
  • As Billing Services: you must fill out this form for each provider you will be submitting on behalf of

Section 2:

  • Check the Box to “Add New Provider”
  • Enter the Provider’s Name, Medicaid Number, and NPI
  • Enter the Provider’s Address and Contact information
  • The Provider, or authorized representative, must print their name, sign and date the application

Section 3:

  • Please enter the Software Vendor information listed above for your convenience
  • Version is 4.0.11
  • Release date: Sep 18th 2012

ERA EDI Agreement

Please fill out this form after receiving your Submitter ID.

Section 1:

  • Check the box for “Medicaid”
  • Check the box for “Web”

Section 2:

  • Check the box to Add New Provider
  • Enter the Providers name
  • Enter the Submitters name (Either the name of the Provider, Billing Service, or Clearinghouse)
  • The date entered should be on a Monday, per their recommendation
  • Print Name, Sign and Date the application
  • Enter the Medicaid Provider ID, and Group NPI
    • The ID listed should be the NPI of the Provider/Group that is registered with Molina Medicaid
  • Enter the Name of the Provider
  • Enter the Provider’s Demographic and Contact information

Section 3:

  • Enter the business name of the Provider/Submitter or Billing Agent/Submitter who will be receiving the ERAs
  • Enter the Submitter ID assigned to you by Molina Medicaid
  • Enter the demographic and contact information

Section 4:

  • Check the box for 5010

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail or Fax the enrollment forms reflecting original signatures to:

Via U.S. Mail
Provider Enrollment
Molina Medicaid Solutions
P.O. Box 4804 Trenton, New Jersey 08650 – 4804

Other Carriers
Provider Enrollment
Molina Medicaid Solutions
3705 Quakerbridge Road, Suite 101
Trenton, New Jersey 08619

It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately 2 weeks from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after 2 weeks, please call the NJ Medicaid EDI Support Center at: 609-588-6051


Once you have received your Submitter ID and Password from NJ Medicaid please call the SolAce Support Team and set an appointment for a Mailbox setup.

Testing is not required at this time; we are an approved vendor for Professional Claims Submission and Inquiry with NJ Molina Medicaid. If you bill institutional claims (UB04) and wish to use SolAce to submit to NJ Medicaid, Please call the SolAce Support Team at 602-439-2525.

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customers From our customers

I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.

Shani Madaminova,
Best Home Care, Inc
Jersey City, NJ

SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.

Susie Doran Carter, Westcare Management, Inc.
LTC Medicare Consultant and Billing Service
Salem, OR

I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.

Carolyn Boles
From the office of Donald J. Boles Jr. MD PC
Tempe, AZ

SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.

S. Bowling
Idabel, Oklahoma

Easy to use, Customer support has always been excellent, Thanks SolAce Team.

Carl Shepherd
IT Administrator
Dublin, GA

I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.

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