How to get started
1. Enroll as a North Dakota Medicaid 1915(i) provider with the State of North Dakota.
a. Make sure to enroll all affiliated clinics and providers who may be rendering services.
b. Enrolled 1915(i) providers choose to offer one or more of the following services: Care Coordination, Respite, Training and Support for Unpaid Caregivers, Non-Medical Transportation, Family Peer Support, Peer Support, Supported Education, Benefits Planning, Pre-Vocational Training, Supported Employment, and Housing Support.
2. Enroll in our BCBSND Medicaid Expansion network by contacting our Provider Contracting department at firstname.lastname@example.org.
3. Once you are enrolled, verify the member’s benefit requirements for eligibility to receive 1915(i) services by calling BCBSND at 701-282-1003 during normal business hours.
a. It is the provider’s responsibility to verify a member’s 1915(i) eligibility, reasons for this include, but are not limited to, a member being eligible for Medicaid Expansion but not eligible for 1915(i) services. A member may lose eligibility for 1915(i) services during their treatment. It is the provider’s responsibility to verify a member’s 1915(i) eligibility.
4. Submit a precertification on behalf of the member through the Availity Essentials provider portal.
Things to note for precertification/authorization requests:
a. The request should be submitted prior to seeing the member.
b. Authorizations can only start the date the request is received.
c. The provider’s name on the request should be the practice name, not the individual rendering the service.
d. If the authorization is incomplete and missing information necessary to complete the request, a fax will be sent back to obtain the information to the number listed on the initial authorization request.
e. If you have a question on your request or need the status of your request, call the Utilization Management department by calling 1-800-952-8462.
5. Start seeing members.
6. Begin submitting claims.