File An Appeal
Applicants or recipients of Medicaid who are dissatisfied with a decision made by the county agency or the North Dakota Department of Human Services, or who have not had their application acted on with reasonable promptness, may appeal to the North Dakota Department of Human Services.
To File an Appeal:
- An appeal can be filed verbally over the phone, or in written format by email, fax or mail.
- A request to appeal must be filed no later than 30 days from the date the notice of action is mailed.
- You can use SFN 162: Request for Hearing to file the appeal but it is not required.
- You are not required to sign SFN 162: Request for Hearing to submit the appeal request.
- If you do not use SFN 162: Request for Hearing, please provide your name, contact information, and program decision or error that you are appealing.
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Click this button to submit an appeal request online |
Contact Information
Appeals Supervisor, Legal Advisory Unit
N.D. Department of Human Services
600 E Boulevard Avenue, Dept. 325
Bismarck, ND 58505-0250
Phone: (701) 328-2311
Toll Free: (800) 472-2622
711 (TTY)
FAX: (701) 328-2173
Email: dhslau@nd.gov
Nondiscrimination Policy and Related Information
Language Assistance and Auxiliary Aids and Services are available at no cost.
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