Provider Enrollment Information

Medium

Resources 

     Provider Enrollment Updates and Introductions (Powerpoint) 

Eligibility

To be eligible for enrollment, a provider must:

  • Provide services to at least one North Dakota Medicaid-eligible recipient.
  • Meet the conditions regulating the specific type of provider, program and/or service.
  • Hold a current license, certification, accreditation or registration according to North Dakota state laws and regulations.
  • Providers must pass the enrollment screening process. 

Application Information

All providers are required to apply for enrollment electronically on the ND Health Enterprise MMIS portal. The exception is Qualified Service Providers.

ND Health Enterprise MMIS Web Portal

All enrollment documentation submitted must include the application tracking number (ATN) from the online enrollment application.

  • Select and fill out the entire packet that applies to your provider type and specialty
  • Attach the required documents and
  • Sign the signature pages for the packet to be considered complete.

You may also use the MMIS web portal to enter claims, upload batch transactions and get real-time access to member eligibility, claims status, remittance advice, payment status and claims history.

Medium

Enrollment

Use the following resources to submit both the online and documentation portions of your application. The documentation portion cannot be attached to the online application, so you must submit them to Noridian by email or fax.

Medium

 

Resources

Required Documents 

Resources

Required Documents

Medium
Medium

Revalidation Information

Revalidations are required to be done for all provider records, regardless of provider type, at least every five years.  

QSPs will receive a revalidation notice through the QSP enrollment portal.

Review the revalidation list for providers who have upcoming or past due revalidations.  Click on the list and do a Ctrl F to search for your name. 

If your enrollment is included on the revalidation list, submit the applicable revalidation checklist. 

  • Select and fill out the entire packet that applies to your provider type and specialty
  • Attach the required documents and
  • Sign the signature pages for the packet to be considered complete.
Medium
Medium

Taxonomy Codes

Taxonomy codes identify a health care provider by the service they provide and area of specialty https://www.cms.gov/Medicare/Provider-Enrollment-and Certification/MedicareProviderSupEnroll/Taxonomy.

Providers are required to submit taxonomy codes when submitting paper or electronic claims to ND Medicaid. This excludes Qualified Service Providers (HCBS claims), transportation claims and claims submitted by other atypical provider types.

Medium

If you are adding or updating a taxonomy use the SFN 1302 Request to Add/Change Taxonomy

There are two separate taxonomy code sets, one for individual providers, and one for group providers. Individual taxonomies cannot be used for group enrollments, just as group taxonomies cannot be used for individuals.

Determine the taxonomy you are going to be billing by searching the following lists to see which specialty and provider type corresponds to that taxonomy.

How to Search

  • Open the document
  • Hold the Control Key and press F
  • A search box will be displayed in the upper right of the screen
  • Enter your search criteria (NPI number)
  • Click the NEXT button in the search box to locate the NPI number you are inquiring on

Instructions to validate your taxonomy code(s) in Enterprise MMIS

Taxonomy codes are:

  • Maintained on the provider's record and will be verified based on licenses and certifications
  • Submitted to North Dakota on claims and other items such as service authorizations
  • Used during adjudication
  • Required on paper and electronic claims. Claims without the required taxonomy code will be denied.

Taxonomy codes listed on a claim MUST match the taxonomy codes on a provider's record or the claims will be denied.

Questions about taxonomy codes, changing taxonomy codes or other enrollment information should be emailed to NDMedicaidEnrollment@Noridian.com.

Medium

Search for Enrolled Providers

Use this search before completing an application. If a provider is enrolled, do not submit a new application.

Medium
Medium

Options for Submitting Provider Enrollment Documentation

Electronic Secure Link:

For those providers that wish to send the required documentation via email, you must request access to a secure link by sending an email to NDMedicaidEnrollment@noridian.com. An email will be sent back to you with a link to a secure site to send your documents to the enrollment application.

Fax:

Providers may fax the required documentation to (701) 433-5956
ATTN: NDM Provider Enrollment

Mail:

Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment
PO Box 6055
Fargo, ND 58108-6055
Phone: (877)328-7098 (toll-free) or (701)328-7098 option 1

Questions? Need Help?

Medium
h2
Left
Questions? Need Help?

Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment
PO Box 6055
Fargo, ND 58108-6055

Email: NDMedicaidEnrollment@noridian.com

Phone: (877)328-7098 (toll-free) or (701)328-7098 option 1
Live support 8 a.m. - 5 p.m. CT, Monday - Friday. After-hours voicemail available.

Fax: (701) 433-5956

Developmental Disability Providers

Phone: (701) 328-8935
Toll-Free: (800) 755-8529

Qualified Service Providers

Enrolling as a Qualified Service Provider