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Highmark to start processing claims in New Jersey

Highmark Medicare Services has announced that it will begin processing Medicare part A claims in New Jersey on September 1, 2008, and part B claims on November 14, 2008.

In October 2007, the Centers for Medicare & Medicaid Services awarded Highmark Medicare Services the Jurisdiction 12 (J12) Medicare contract to provide the Medicare fee-for-service part A and part B administrative services for the states of Pennsylvania, Maryland, New Jersey, Delaware and the District of Columbia.

The award is part of a congressional requirement to replace all current
Medicare part A and B contracts with new contract entities called Medicare Administrative Contractors (MACs). In fiscal year 2007, Highmark Medicare Services processed about 48.8 million claims and served approximately 2.3 million beneficiaries and 57,000 providers.

As the MAC for J12, Highmark Medicare Services is expected to process approximately 131 million claims annually, accounting for more than 11% of the national Medicare fee-for-service workload. Highmark Medicare Services will be working on behalf of approximately 4.2 million beneficiaries and 137,000 physicians and practitioners.

As a MAC, Highmark Medicare Services will serve as a single point-of-contact entity processing Medicare part A and B claims from hospitals and other institutional providers, physicians and other practitioners within the J12 region.

Patrick Kiley, president of Highmark Medicare Services, said: As this work transitions from other contractors to Highmark Medicare Services, we are committed to making this as seamless as possible for Medicare beneficiaries and health care providers.