Contact SDS directly. All trading agreements would come through them exclusively. You can contact them directly at stream.support@sdata.us.

Please contact your billing software vendor for details.

We recommend that you start by sending 20-30 claims to ensure no issues exist. We also suggest that you contact the EDI Support line at EDI@jeffersonhealthplans.com after submitting the first batch of claims so that we can analyze them for any potential issues.

Email is very different from EDI. The EDI data is transmitted in a structured format, based on the use of transaction standards, which ensures that all participants use a common language.

Yes, there are two types of reports available to providers:  

• RPT01/RPT05: This report identifies all claim rejections with invalid and/or missing data that have been sent back to the provider from SDS. Claims rejected at this level cannot be identified by us and are rejected before reaching our claims processing system. To inquire about claim errors found on this report, please contact your billing software vendor.
• RPT10/RPT11: This report identifies all claim rejections with invalid and/or missing data that have been sent back to the provider from us. To inquire about claim errors found on this report, please contact the EDI Support Line at EDI@jeffersonhealthplans.com and provide the Carrier Reference Number (Car Ref #) of the error(s) in question to the representative.

Payor ID. The following payor IDs are required on claims sent electronically for our members:

• Medicare PPO: RP099
• New Jersey Medicare PPO: NJ099
• ALL other products (Medicaid, CHIP, Medicare HMO/DSNP, Individual and Family): 80142

National Provider Identifier (NPI). Failure to include this information will result in rejection of the claim.

An NPI is assigned to the provider by the Centers of Medicare and Medicaid Services (CMS). It is a valid 10-digit numeric value based on rules supplied by CMS.

If you do not have the appropriate equipment for the electronic claims process, we suggest that you contact Smart Data Solutions (SDS) at stream.support@sdata.us or your billing software vendor for more information.