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ND Medicaid Provider Updates

Posted 5-17-2022

Noridian is currently reviewing the following submission dates as of Monday, May 16 for workloads:

  • Individual Application – 2/18/2022
  • Group Application – 2/22/2022
  • Individual Revalidation – 3/15/2022
  • Group Revalidation – 4/29/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 5-16-2022

The Medication Therapy Management Provider (MTM) Manual has been updated and renamed Provider Manual for Pharmacy Medical Billing. It now includes additional medical services that may be billed by pharmacies/pharmacists.

Posted 5-13-2022

The General Information for Provider Manual has been updated. This manual covers areas regarding provider enrollment and Medicaid covered services.

Posted 5-12-2022

Attention All Providers: Reminder that the North Dakota Department of Human Services  Timely Filing Policy has changed for claim dates of service on or after Jan. 1, 2022.

Posted 5-10-2022

Noridian is currently reviewing the following submission dates as of Monday, May 9 for workloads:

  • Individual Application – 2/14/2022
  • Group Application – 2/15/2022
  • Individual Revalidation – 3/15/2022
  • Group Revalidation – 4/24/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 5-2-2022

Noridian is currently reviewing the following submission dates as of Monday, May 2 for workloads:

  • Individual Application – 2/11/2022
  • Group Application – 2/14/2022
  • Individual Revalidation – 3/15/2022
  • Group Revalidation – 4/5/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 4-25-2022

Noridian is currently reviewing the following submission dates as of Monday, April 25 for workloads:

  • Individual Application – 2/10/2022
  • Group Application – 2/15/2022
  • Individual Revalidation – 2/14/2022
  • Group Revalidation – 3/16/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 4-19-2022

Noridian is currently reviewing the following submission dates as of Monday, April 18 for workloads:

  • Individual Application – 2/8/2022
  • Group Application – 2/8/2022
  • Individual Revalidation – 2/9/2022
  • Group Revalidation – 3/1/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 4-18-2022

Attention Providers: Therapy claims (special education unit therapy claims excluded) with dates of service July 1, 2022 and after will require the ordering provider to be submitted on each claim submission.

837P Transactions
The referring/ordering provider should be reported at the claim level in Loop 2310A for services such as diagnostic and laboratory services. To report therapy services at the claim detail line level, report the ordering provider in Loop 2420E and/or the referring provider in Loop 2420F.

When there is only one referral use code “DN – Referring Provider." Use“P3 – Primary Care Provider” in the second iteration of the loop to indicate the initial referral from the primary care provider. Use “DK –Ordering Provider” to indicate the ordering provider.

837I Transactions
The referring provider should be reported at the claim level in Loop2310F when the referring provider is different than the attending provider. When the referring provider on a claim detail line is different than what is reported in Loop 2310F, they are reported in Loop 2420D. An ordering provider is not reported on an 837I. Use “DN – Referring Provider” to indicate the referring provider.

Questions? Reach out to the ND Medicaid call center at 877-328-7098 or mmisinfo@nd.gov.

Posted 4-5-2022

Noridian is currently reviewing the following submission dates as of 4/4/2022 for workloads:

  • Individual Application – 2/8/2022
  • Group Application – 2/8/2022
  • Individual Revalidation – 3/14/2022
  • Group Revalidation – 3/1/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 3-28-2022

All Providers:  The North Dakota Medicaid Program Integrity Unit provided program updates Feb. 23 and 24, 2022 by video conference.  Providers can access the PowerPoint, Q & A and an audio recording of that presentation. 

If you were not sent an email invitation to the event and would like to be included in future video conferences, please email Missy Rosales at melrosales@nd.gov.

Posted 3-28-2022

Noridian is currently reviewing the following submission dates as of Monday, March 28 for workloads:

  • Individual Application – 2/3/2022
  • Group Application – 2/8/2022
  • Individual Revalidation – 2/16/22
  • Group Revalidation – 2/23/22

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 3-28-2022

Attention Providers:  The latest edition of the N.D Medicaid Provider e-newsletter is now available.

In the March 2022 edition, learn about member eligibility renewals, primary care provider referrals, a new timely filing policy for Medicaid claims, common reasons why claims are denied or suspended and more!

If you have trouble viewing the e-newsletter, cut and paste the URL into another web browser – Chrome, Firefox or Internet Explorer or Safari for Mac users.

A PDF verison is also available.

We welcome your feedback by email to dhsmed@nd.gov.  

Thank you for being a N.D. Medicaid provider and serving our Medicaid members.

Posted 3-21-2022

Noridian is currently reviewing the following submission dates as of 3/21/2022 for workloads:

  • Individual Application – 2/3/2022
  • Group Application – 1/26/2022
  • Individual Revalidation – 2/9/2022
  • Group Revalidation – 2/28/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an Approval letter/email within the next 5 business days.

Posted 3-18-2022

As of May 1, 2022, North Dakota Medicaid will no longer be accepting any paper dental claims.  Paper dental claims received on or after May 1, 2022, will be returned to the provider unless an exemption has been approved by North Dakota Medicaid. 

Requesting an Exemption
Providers who are not included on the automatic exemption list above and wish to receive an exemption, will need to submit an exemption request in writing or via email using the department approved form.

Submit by fax, email, or mail to:

Fax:  701-328-1544 - ATTN:  Michelle Adams
Email: mladams@nd.gov
Mailing Address:

Medical Services – ATTN: Michelle Adams
ND Department of Human Services
600 E. Boulevard Ave., Dept 325
Bismarck, N.D. 58505-0250

All dental claims must be submitted as/an 837D electronic transaction or through the ND Provider Web Portal.

Electronic claims submission instructions can be located on our webpage.

NOTE: FAXED claims are not accepted for submitting for payment.

If you have questions or concerns, contact ND Medicaid Call Center at 877-328-7098 / 701-328-7098 or email mmisinfo@nd.gov.

Posted 3-14-2022

Noridian is currently reviewing the following submission dates as of March 14, 2022 for workloads:

  • Individual Application – 2/3/2022
  • Group Application – 1/26/2022
  • Individual Revalidation – 2/2/2022
  • Group Revalidation – 2/23/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 3-8-2022

Noridian is transitioning to a new platform to assist in automating many of the enrollment and revalidation processes. Based on that transition, the submission dates that were posted for 2/28/2022 are effective for this week too.

Posted 2-28-2022

Noridian is currently reviewing the following submission dates as of Monday, February 28 for workloads:

  • Individual Application – 2/8/2022
  • Group Application – 1/26/2022
    • FYI that with OnBase implementation really busy last week, our approvals are further behind than we have been trending earlier this month. We’ll work to catch up on those after the team is trained today and we’re working live in OnBase and when the QSP transition steadies a bit (likely next week)
  • Individual Revalidation – 2/9/2022
  • Group Revalidation – 2/14/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an Approval letter/email within the next 5 business days.

Posted 2-23-2022

Noridian is currently reviewing the following submission dates as of Wednesday, February 23 for workloads:

  • Individual Application – 2/8/2022
  • Group Application – 1/18/2022
  • Individual Revalidation – 2/7/2022
  • Group Revalidation – 2/14/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an Approval letter/email within the next five business days.

Posted 2-14-2022

Noridian is currently reviewing the following submission dates as of Monday, Feb. 14 for workloads:

  • Individual Application – 2/7/2022
  • Group Application – 1/5/2022
  • Individual Revalidation – 2/3/2022
  • Group Revalidation – 2/8/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 2-11-2022

Medical Services' Program Integrity Unit will host a provider update Feb. 23 and Feb. 24, 2022.  The agenda is here.

Posted 2-8-2022

Noridian is currently reviewing the following submission dates as of 2/8/2022 for workloads:

  • Individual Application – 1/24/2022
  • Group Application – 1/5/2022
  • Individual Revalidation – 2/3/2022
  • Group Revalidation – 2/4/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 1-31-2022

Noridian is currently reviewing the following submission dates as of Jan. 31, 2022 for workloads:

  • Individual Application – 1/24/2022
  • Group Application – 1/5/2022
  • Individual Revalidation – 1/28/2022
  • Group Revalidation – 1/26/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 1-26-2022

Attn: Dental Providers - The ND Medicaid Dental Manual has been updated and is now available. This manual includes all CDT 2022 code updates.

Posted 1-18-2022

Noridian is currently reviewing the following submission dates as of 1/17/2022 for workloads:

  • Individual Application – 1/3/2022
  • Group Application – 12/7/2021
  • Individual Revalidation – 1/12/2022
  • Group Revalidation – 1/10/2022

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 1-11-2022

Noridian is currently reviewing the following submission dates as of 1/10/2022 for workloads:

  • Individual Application – 12/22/2021
  • Group Application – 12/7/2021
  • Individual Revalidation – 12/29/2021
  • Group Revalidation – 12/23/2021

Any submissions on or before these submission dates can expect either an email/phone call for corrections needed or an approval letter/email within the next five business days.

Posted 1-6-2022

A new provider manual specific to behavioral health services covered by ND Medicaid is now available. The manual contains chapters on:

  • Partial Hospitalization Psychiatric (PHP) Services
  • 1915(i) Behavioral Health Services
  • Psychiatric Residential Treatment Facilities (PRTFs)
  • Qualified Residential Treatment Programs (QRTPs)
  • Rehabilitative Services
  • Substance Use Disorder Treatment Services

Posted 1-3-2022

DME Fee Schedules and the Professional Fee Schedule, both effective Jan. 1, 2022, have been posted to the ND Medicaid provider fee schedule webpage.


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