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

A: NEMT providers need to get an authorization prior to providing the transportation service. If authorization is not given prior to the ride, the claim will deny as provider liable, and the NEMT provider will not receive payment.

A: Providers need to get an authorization prior to providing the meals and/or lodging service. If authorization is not given prior to the service, the claim will deny as provider liable, and the provider will not receive payment.

A: All services provided on the same date of service must be billed on the same claim. If the additional ride(s) was approved under a different authorization, the additional authorization number can be listed in the authorization field of the Availity claim screen.

A: North Dakota requires that out-of-state providers enroll in the ND Medicaid program to be reimbursed.

Providers should check enrollment requirements before submitting the claim. If a provider submits a claim without enrolling with Medicaid, or following the above processes, their claims will be denied, and they will receive a non-covered provider liable denial on the provider remittance.

Out of state, non-ND providers will send directly to BCBSND.

A: Whether submitting a new claim or a replacement correction claim, submit the claim form, invoices, and any additional documentation to support the charges. 

A: An example of when to submit a new:
 

• The initial submission of charges
• If a provider submitted incorrect patient data such as member name, Unique Member Identifier (UMI or Member ID), or date of birth and the claim rejected as unable to identify a match to the member

An example of when to submit a void:
 

• A charge needs to be withdrawn

An example of when to submit a replacement claim:
 

• A change or correction of information such as a procedure code, milage charge etc. needs to be replaced

A: Replacement claims must be submitted within 90 days from the initial/original claim remittance date, exceptions apply for the following:
 

• Coordination of Benefits
• Workers Compensation
• No-Fault
• Subrogation
• Third-Party Payers  

A: To assist in timely filling:
 

• Make sure the information submitted is correct and accurate
• Make sure the information is legible, whether handwritten or typed
• Utilize the correct procedure code for the type of transportation
• Input the correct number of milage units

A: The claim may deny or be returned. BCBSND will process a claim according to the information submitted. 

A: Contact the Customer Services Center to request more information as reasons may vary.

Example: Claims total charge was billed higher than the allowed amount of the units billed. 

A: You may first want to contact the Medicaid Expansion Contact Center to discuss the claim. If a provider still disagrees with a BCBSND determination on benefits or claims, the decision may be appealed. For NEMT providers, this will most likely fall into the post service claim appeal, which could include scenarios such as a claim denying for timely filing.

You would not use an appeal for something that can be done via the correction process, such as adding the authorization number to the claim if it were missed upon original submission.

More information regarding the appeal process and timeframes can be found on the BCBSND Appeals webpage.

A: Yes. If you have questions regarding a ride authorization, eligibility, claims, etc. reach out to the Medicaid Expansion Provider Services department as soon as possible. Even if you do not have specific member details, you can still call to ask questions. Please note, the more information you have when calling, the better.

When calling you will be prompted through the IVR system. Select option 1, then say “no”, then say “other”, then say “2” or remain on the line. This is subject to change, please ensure you listen to the prompts prior to submitted a response.

A: As of 7/15/2025, the Medicaid Expansion Non-Emergency Transportation, Meals and Lodging Billing Form is no longer accepted. Providers whether providing NEMT or meals and lodging, need to submit their claims within the Availity Essentials Provider Portal or through their clearinghouse. 

Additional guidance on how to submit a claim can be found in Availity Payer Spaces- Non-Emergency Medical Transportation (NEMT) Medicaid Expansion Providers Only- Availity Provider Resource Guide. To access Payer Spaces, you must first be logged into Availity. 

A: Start by contacting Availity Essentials technical support at 800-282-4548. If they cannot resolve your issue and need to research further and you are approaching timely filing, contact the BCBSND Medicaid Expansion Provider Services department.