Claims Submission

NDMS Definitive Care Reimbursement Program

Claim Formats

When possible, providers should submit claims electronically via a claims clearinghouse service to payer code NDMSJ29 (HHS NATIONAL DISASTER MEDICAL SYSTEM-J-29). For all electronic claims received, an electronic remittance advice will be returned which will make payment reconciliation more efficient for the provider.

If needed or preferred, the program will continue to accept hard copy claims as well. Hard-copy claims must be submitted to Apprio using industry standard pre-printed claim forms:

• Institutional claims must be submitted using the CMS-1450 (UB-04) claim form
• Professional claims must be submitted using the CMS-1500 claim form
• Dental claims must be submitted using the ADA Dental claim form

Secondary claims should be mailed to the program in hard-copy format along with a copy of the remittance advice or explanation of benefits document received from the primary payer.

Mail hard-copy claims to J29 at 1111 Benfield Blvd, STE 114 Millersville, MD 21108.

Claim Submission Quick Guide

The NDMS Definitive Care Reimbursement Program has compiled a NDMS Claims Submission Quick Guide to assist claimants with the submission process. The guide provides benefit examples that are claim eligible and a claim submission checklist to follow when submitting a claim.

Claim Submission Quick Deadline

The NDMS Definitive Reimbursement Program is currently not activated and is not accepting any claims.

Copies of Medical Records for Inpatients

Please note that the NDMS may require copies of medical records for all patients who are admitted as inpatients by facilities to support their follow up utilization and efficacy studies.

Appeals

In the event that a provider would like to appeal a claim adjudication decision or payment amount, the NDMS Definitive Care Appeal form should be completed and submitted with all supporting documentation within 45 days of receipt of a remittance advice or claim denial notice from the program. Mail appeals to: 

ATTN: NDMS Appeals J29
1111 Benfield Blvd, STE 114
Millersville, MD 21108

or fax them to: 202.892.7200, or send via encrypted email only to: ndms@j29inc.com​

Appeals Submission Deadline

The deadline for filing an appeal is 45 days after receipt of the Explanation of Benefits from NDMS.