Frequently Asked Questions
What is the ND MMIS Web Portal?
The North Dakota Medicaid Management Information System Web Portal.
What are the benefits of the new system?
The North Dakota Medicaid Management Information Systems Web Portal offers more options for providers. Through the self-service web portal, providers will be able to do more online such as enroll in the ND Medicaid program, submit claims and receive payments electronically. Providers will also be able to inquire on payment information. If claims are denied, providers can find out the reasons for denial. This online access to claims will help providers identify errors, which could decrease the amount of time needed to process and pay claims. The ND MMIS Web Portal will also benefit Medicaid Members. Members will have the capability to use the website to learn more about Medicaid benefits and coverage, and to find participating health care providers in their area.
Will providers need any additional equipment to access the new MMIS system?
The ND MMIS Web Portal is web enabled and can be accessed from any computer using Internet Explorer 7.x and higher or Firefox 3.x and higher. Adobe reader will also be required to retrieve certain documents.
What is a trading partner?
A trading partner is an entity that submits electronic HIPAA transactions to exchange business information electronically.
How is the ND MMIS Web Portal accessed?
Providers will be required to obtain a user ID and password. Providers and trading partners must be enrolled with North Dakota and have received their provider or trading partner ID.
Members will be required to obtain a Personal Identification Number (PIN) to access secure information that is only available to eligible members. Members will login by entering their Member ID Number as it appears on the Member ID Card.
What is the availability of the system?
The system is available 24/7 with the exception of downtime for maintenance.
Electronic Data Interchange (EDI)
Can a provider who elects to receive an 835 RA electronically do so in the new system?
Yes. Providers will have a secure mailbox setup in which you can download the 835 transactions.
Can providers still receive a paper Remittance Advice (RA)?
Yes. Paper RA’s will still be available for those who do not elect the 835 RA.
Where can I find the provider taxonomy codes?
Provider taxonomy codes and other codes are available on the Washington Publishing Company Web site.
Does the Department require an agreement for HIPAA compliance between a health care provider/trading partner and the State?
Yes, the Department will require a trading partner agreement between any healthcare provider or entity that wishes to submit transactions electronically.
In the new system will there be any changes in how we bill using our Medicaid number?
The National Provider Identifier (NPI) and taxonomy will be required on all claims submitted by healthcare providers who bill on paper UB04, CMS1500, and the 2006 ADA Dental claims. The Medicaid provider number will only be accepted on HCBS/DD or Travel and Lodging claims.
Will we be able to do Electronic billing in the new system and if so are there any changes?
There will be three ways a provider can submit claims:
- The ND MMIS Web Portal
- Electronic Data Interchange (EDI)
Use of the ND MMIS Web Portal will allow the providers to enter their claims electronically and submit them directly to DHS and immediately see the results of the claims submission.
We are a dental provider, will we be required to bill differently?
The Department will only support the 2006 American Dental Association claim form. All other dental forms will be returned. Utilizing the web portal will provide timely submission and inquiry on claim status. All claims must have a NPI and a taxonomy code.
I currently submit paper claims. Will that be changing in the new system?
Providers who submit on paper UB04, CMS 1500 or 2006 ADA Dental claim forms must have a NPI and a taxonomy code. The NPI and taxonomy code must be submitted on all claims. The HCBS/DD and Travel and Lodging providers will have new forms and are excluded from the NPI requirement and taxonomy.
I am an active provider with ND Medicaid will I need to enroll in the new system?
The Department will require ALL providers, current and new, to enroll into the new system.
What provider identifier will North Dakota require for electronic claims?
Providers who are subject to the Federal HIPAA NPI guidelines are required to submit electronic claims and other transactions using their NPI and a taxonomy code.
I am a Qualified Service Provider (QSP) will the way I bill be affected?
Yes. The State will continue to offer a way for QSP's to bill electronically but how you access the system will change. The system will also have a different look. QSP's will sign on to the system and use a new tool called the ND MMIS Web Portal to submit claims. The State encourages QSP's to use this method. Billing electronically will decrease the processing time that a provider will wait for payment and will allow the provider to know if there are errors on the claim. The State will continue to allow paper billing for those who prefer not to access the faster online web method.
How will I verify eligibility?
Providers will have the ability to check member eligibility 3 different ways:
- Online using the Web Portal
- Automated Voice Response System (AVRS)
- Swipe card also known as Medifax.
Will the Department be holding training sessions for providers to be trained using the new MMIS system?
Yes, the Department will provide training on how to use the new system. Along with training sessions the Department will be updating provider billing materials. More details will be available at a later date.
What is a service authorization?
Currently we refer to these as Prior Authorization
Will Providers have the ability to submit service authorizations online?
Yes, providers will be able to sign on to the ND MMIS Web Portal and submit a Service Authorization and check the status.
- NPPES (National Plan & Provider Enumeration System) https://nppes.cms.hhs.gov/NPPES/Welcome.do
- NUCC (National Uniform Claims Committee) http://www.nucc.org
- NUBC (National Uniform Billing Committee) http://www.nubc.org
- WPC (Washington Publishing Company) http://www.wpc-edi.com
- CMS (Centers for Medicare and Medicaid Services) http://www.cms.hhs.gov