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Primary Care Case Management Program

The Primary Care Case Management Program helps ensures that Medicaid members have a regular health care provider who coordinates their care.

Program participants are required to select a primary care provider to see for all medical visits. If a Medicaid member does not select a primary care provider, one will be assigned to him or her.

A primary care provider:

  • Provides routine care (physicals, prescription refills, vaccines)
  • Addresses common illnesses and injuries (colds, flu, broken bones, etc.)
  • Understands a person’s medical history
  • Refers members to specialists, if needed
  • Provides wellness, prevention and other educational information

Having a primary care provider also creates a trusting relationship, which helps people talk about health issues or concerns they may have.

Recipient Information

You are required to receive all non-emergent health care services from your primary care provider. If you need a specialty or hospital services, a referral from your primary care provider is required before the appointment. Some services do not require a referral.

Review the handbook for information about the program, referral process, copay amounts, covered services and other topics. It also answers some commonly asked questions.

If you have questions, contact your county case worker or the ND Medicaid office.

Primary Care Provider Information

Information on the Primary Care Case Management Program can be found in the General Information for Providers Manual in the Managed Care Chapter.

Any questions regarding the Primary Care Case Management Program can be emailed to dhsmci@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) 328-7068
Toll-free: (800) 755-2604
ND Relay TTY: (800) 366-6888 or 711
Fax: (701) 328-1544

 

 

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