ND Health Enterprise Medicaid Management Information System (MMIS)
Important Message: Suspended Claims (Oct. 7, 2015)
With the launch of ND Health Enterprise MMIS, the Department of Human Services is committed to ensuring the highest quality and accuracy in claims processing. This process includes a step that places claims in a suspended status.
A suspended claim means the claim has been received and requires additional action to move to a completed status. This may be an additional review for medical necessity, checking for a service authorization, waiting for an attachment or supporting documentation, or verifying member or provider enrollment information.
PLEASE allow sufficient time for suspended claims to complete processing and do not resubmit a duplicate claim.The recent Transition Period during which claim processing was on hold has resulted in higher than normal claim volumes.
Thank you for your patience during this start-up period while the Department is working diligently to process all claims as soon as possible.
- Providers can check claim status through the Automated Voice Response System by dialing 1-877-328-7098 and selecting option 4. Claim status can also be obtained through the secure provider portal.
We appreciate your participation in the ND Medicaid program and continuing to care for our North Dakota citizens.
The new ND Health Enterprise MMIS is now live! - Effective 8 a.m. (CT) October 5, 2015.
ND Health Enterprise MMIS is available to all active enrolled Medicaid providers. Users can now access the web portal.
The ND Health Enterprise MMIS will be available to providers who participate in:
- North Dakota Medicaid
- Children’s Health Insurance Program (Healthy Steps)
- Home and Community-Based Medicaid Waiver Services
Provider News and Updates
Oct. 5, 2015 - Important Notice - ND Health Enterprise MMIS is now available - Effective 8 a.m. (CT) October 05, 2015. ND Health Enterprise MMIS is available to all active enrolled Medicaid providers. Users can now access the web portal.
Sept. 25, 2015 - Important Notice - Transition to New Pharmacy Claims Payment System
Aug. 3, 2015 - In preparation for the ND Health Enterprise MMIS, the Department is now instructing providers to include their taxonomy code on electronic claims submitted for processing with the current Legacy MMIS system. This action is to help providers adjust to the new requirements.
All new and existing providers MUST complete a web-based enrollment application to use the ND Health Enterprise MMIS.
IMPORTANT UPDATE: The Enterprise provider enrollment application is unavailable from August 21, 2015 through October 4, 2015. New applications, applications in process, and updates to Enterprise provider enrollment records will be available again on October 5, 2015 as a component of the new ND Health Enterprise MMIS system Go-Live.
Please check back later to confirm application status and request provider enrollment record changes. We appreciate your patience during the transition period as the Department completes the necessary work for this important system change.
Learn more about taxonomy codes and their role in submitting claims to the ND Health Enterprise MMIS.
Training and Support
Providers have accessed various training opportunities to prepare for new ND Health Enterprise MMIS.
- Important: Phase II provider type specific training materials.
Companion guides are for N.D. Trading Partners when ND Health Enterprise MMIS goes live.
Paper Claim Instructions
Paper claim instructions and computer-based trainings provide field level instruction on how to complete a claim form for claims submitted to the ND Health Enterprise MMIS.
Claims Submission Guidelines
Claims Submission Guidelines outline policy and provider billing instructions for claims submitted to the ND Health Enterprise MMIS.
N.D. Department of Human Services
Medical Services Division
600 East Boulevard Avenue, Dept. 325
Bismarck, N.D. 58505-0250
Phone: (800) 755-2604