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North Dakota Medicaid is required to make sure members received services that providers billed on your behalf. A provider may be a medical professional, pharmacy, or medical facility. This helps us ensure that only services provided to you are paid for by Medicaid.
We conduct a random selection of services on a regular basis. We send a form to our members asking them to confirm that the selected service was provided.
If you have received the form below, please follow the instructions.
- If you did not get the service listed, we need you to complete and return the form. This tells us that you are not sure you had that service, and we should review that service further.
- If you did get the service listed, you don’t need to complete or return the form. When we don’t receive the form back, we understand that the service was provided.
Forms can be returned by:
- Email: medicaidprogramintegrity@nd.gov
- Mail: Department of Health and Human Services
Program Integrity Unit
600 East Boulevard Avenue Dept 325
Bismarck, ND 58505-0250
If you have questions:
- Call: 1-800-755-2604, option 3.
- TTY: 711