Medicaid Expansion Program - Provider Information

BCBSND administers coverage for North Dakota’s Medicaid Expansion Program, which enables more people to access affordable coverage and preventive services.

While Medicaid Expansion builds on the success of traditional Medicaid, the benefits, systems and credentialing processes of the two programs may differ.

Provider Credentialing and Enrollment

To be a provider in the North Dakota Medicaid Expansion Program, you must become credentialed with the State of North Dakota and BCBSND

Current BCBSND Providers

To request a Medicaid Expansion addendum, send an email to providercontracting@bcbsnd.com.

New BCBSND Providers

Once enrolled with the State of North Dakota, you can join the BCBSND network and become credentialed for the North Dakota Medicaid Expansion Program by applying to be a BCBSND provider.

1915(i) Provider Group Enrollment Requirements

If you are a provider group or practice that is not currently enrolled with BCBSND and want to be credentialed only for North Dakota Medicaid Expansion to provide 1915(i) services, you must enroll with the State of North Dakota. Once directed to the website, click on the Enrollment information link. After enrollment with the State of North Dakota, send an email to BCBSND at providercontracting@bcbsnd.com to enroll within the Medicaid Expansion network. Enrollment with both the State of North Dakota and BCBSND is required.

1915(i) providers who deliver home and community-based services to individuals with behavioral health conditions can view the 1915(i) provider page for more information.

Non-Emergency Medical Transportation (NEMT) and Meals and Lodging Providers

Providers of NEMT, meals and lodging will follow the same enrollment process outlined above for 1915(i) services.

Learn more about these provider processes by visiting the Non-Emergency Medical Transportation (NEMT), Meals and Lodging Provider page.

Pharmacy

Retail outpatient pharmacy benefits are administered by the North Dakota Department of Human Services.

North Dakota Dept. of Human Service Preferred Drug List

A list of Prescription Medications or Drugs that may be covered under the medical benefit and may require Precertification (Prior Approval) for Medicaid Expansion member.                

BCBSND Medicaid Expansion Restricted Use List – Precertification