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


Overview

The BCBSND Medicaid Expansion program provides the opportunity to non-emergency medical transportation (NEMT) providers to coordinate non-emergency medical transportation to and from medical appointments for our North Dakota (ND) Medicaid Expansion members when no other transportation source is available. BCBSND Medicaid Expansion also offers the benefit of meals and lodging when medical/behavioral health services require a member to be away overnight.

BCBSND began administering services for ND’s Medicaid Expansion program effective January 1, 2022. NEMT, Meals and Lodging providers who have credentialed with the North Dakota Department of Human Services (NDDHS) ND Medicaid program can now participate with BCBSND Medicaid Expansion network program.

How to get started

  1. After enrolling with the ND DHHS, enroll in our Medicaid Expansion network by contacting our Provider Contracting department at providercontracting@bcbsnd.com.

  2. Contact BCBSND Medicaid Expansion for ride, meals or lodging authorization procedures prior to providing any service(s). See Authorization Requirements.
  3. Provide the service to member(s).

  4. Begin submitting claims. 

Authorization Requirements

Once an NEMT, Meals or Lodging provider is enrolled with both the DHHS and BCBSND Medicaid Expansion, they will want to contact the BCBSND Medicaid Expansion Customer Contact Center (CCC) for initial instructions on how the authorization process works. The initial contact will include retrieval of information such as, establishing the contact person, this may include an email address, getting phone numbers for BCBSND and members to use, the business operating hours, how many vehicles are available for use, along with expectations, the usage of the electronic communication system and more.

Availity Essentials Provider Portal

Requirements to submit claims

Claims can be submitted through the Availity Essentials provider portal, your chosen clearinghouse or by using the paper form.

Claims must:

  • Be submitted within 180 days from the date of service.
    • Transportation services provided on the same day should be billed on one claim.
  • Have the correct member information such as name, date of birth and insurance ID card number.
  • Have the approved authorization number from BCBSND.
  • Be submitted with all required provider data such as, TIN, provider name, NPI, and Medicaid ID number, as applicable.

Billing Requirements

NEMT, Meals and Lodging providers should refer to their BCBSND provider contract for applicable reimbursement and billable procedure codes.

Below is a breakdown of potentially utilized codes for NEMT, Meals and/or Lodging.

Claim Corrections and Void Requests

Providers may need to correct a claim due to billing errors, by submitting a correction (replacement claim) or void (cancellation) of the previously processed claim. Providers will follow the appropriate guidelines and timeframes to correct claims.

  • Claim corrections must be:
    • Submitted after the original or previously processed claim has finalized.
    • Submitted within 90 days from the finalization date of the prior claim.

Frequently Asked Questions (FAQ)

Questions?

For general questions, call our ND Medicaid Expansion Customer Contact Center at 1-833-777-5779.

For contracting questions, email providercontracting@bcbsnd.com.

For Availity Essentials registration and electronic claim submission questions, contact Availity Client Services at 1-800-282-4548.