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ND Health Enterprise Medicaid Management Information System (MMIS)

Provider Revalidation Process

Revalidations are required to be performed for all provider records, regardless of provider type, at least every five years (this includes ordering or referring physicians or other professionals) per 42 CFR 455.414. The department may, at its discretion require revalidation on a more frequent basis.

Providers must ensure they have a current email address in their enrollment record to receive their revalidation notification.

Once you receive your revalidation notification, read it carefully and follow the instructions.

If a provider fails to furnish the information required to revalidate their enrollment, by their revalidation date, their enrollment span will be termed. Documentation submitted after the revalidation date is not worked as a priority. Providers are encouraged to refer to the Provider Revalidation Dates spreadsheet link below to ensure that they are aware of upcoming revalidation dates.

Provider Revalidation Dates - July 1, 2019 through Sept. 39, 2019 (listed by provider NPI, provider type code, and specialty code)

General instructions – Individual Records

1. Determine if the individual is still providing services for the billing group indicated in the email.

a. If yes, move to step 2.
b. If no, complete the termination form attached to the email and submit by one of the options below.

2. Use the checklist attached to the notification to obtain the required document.
3. Complete the checklist and submit it as a coversheet with your documents.
4. Submit all documentation (completed) within 30 days.

General instructions – Group Records

1. If you are also enrolled with Medicare – or enrollment with Medicare is required for your Provider Type and Specialty, ensure there are no discrepancies between the owners reported to Medicare and the owners reported to ND Medicaid. ND Medicaid will be unable to move forward with the revalidation process until any ownership discrepancies are corrected and the ownership information for both programs match.
2. Use the checklist attached to the notification to obtain the required document.
3. Complete the checklist and submit it as a coversheet with your documents.
4. Submit all documentation (completed) within 30 days.

Three options to send documents to Provider Enrollment (Medicaid only)

  • Regular email: dhsenrollment@nd.gov.
    • (Do not use this method if documents include SSN or bank information, usually only included in group enrollment documents).
  • Fax: Providers may fax the required documentation to (701) 328-1544.
  • Electronically through a secure link: For those providers that wish to send the required documentation via secure email, you must request access to a secure link by sending an email to dhsenrollment@nd.gov. An email will be sent back to you with a link to a secure site to send your required documents. All correspondence must include your application tracking number in order to match the documents to the enrollment application.

To keep all enrollments active, make sure to send in a copy of all licenses (including DEA & CLIA) when they are renewed. This applies to groups and individual enrollments.

Contact

N.D. Department of Human Services
Medical Services
600 East Boulevard Avenue, Dept. 325
Bismarck, N.D. 58505-0250
Phone: (800) 755-2604

 

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