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Medicaid Provider Information

835 Electronic Remittance Advice (ERA) Enrollment

ND Medicaid offers Health Care Claim Payment/Advice (835) Transactions with ND Health Enterprise MMIS.

Providers who wish to receive an 835 transaction will be REQUIRED to complete North Dakota Medicaid Electronic Remittance Advice (835) Enrollment form (SFN 583).

  • SFN 583 can be found at www.nd.gov/eforms/ or by clicking on the link above. If you have any questions, contact the ND EDI Help Desk at 1-844-848-0844 or ndmmisedi@nd.gov.

Contact Information

Medical Services Division
North Dakota Department of Human Services
600 E. Boulevard Ave., Dept. 325
Bismarck, ND 58505-0250
Telephone: (701) 328-2321
Toll-free: (800) 755-2604
ND Relay TTY: (800) 366-6888
Fax: (701) 328-1544
E-mail: dhsmed@nd.gov



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