Provider Update: North Dakota Medicaid Update on HIPAA Transactions

(Updated June 15, 2004)

The N.D. Department of Human Services (DHS) will no longer accept electronic claims that are not in the HIPAA compliant format. Providers who send paper claims may experience a delay in payment, as the process is much slower than submitting electronically.

To test HIPAA transactions contact Medical Services at (701) 328-2321.

4010A transactions

• Trading Partner Agreements (TPA: DN 550) (40kb pdf)
• Electronic Data Interchange (EDI: SFN 548) (12kb pdf), and
• Electronic Funds Transfer (EFT: SFN 661) (20kb pdf) forms

Each provider must complete all three forms to be eligible to begin testing and/or acceptance of electronic transactions.

• The department is testing 4010A transactions (835 and 837 only) with providers. As providers submit their completed TPA, EDI, and EFT forms, the department enters the forms and then contacts providers to schedule testing times.
• The Department is encouraging the use of its Web File Transfer. All Expedite accounts will be transferred to this method of claims transmission.
• Also, in order to reduce administrative expenses, the Department is encouraging submission through the Web, rather than using clearinghouses. The clearinghouses charge the Department a per claim fee.

• Questions To Ask Vendors, TPAs or Clearinghouses (56kb pdf)

 

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