Commercial Provider Manual Updates

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of updates made to the Commercial provider manual over the past thirty days.   


  • Section: Appeals, Grievances and Disputes  
    • New appeals and dispute form links 
  • Section: Electronic Funds Transfer (EFT)
    • Additional information added


  • Section: Disclaimer 
    • Added sentence: If information within the manual conflicts with your contractual Participation Agreement or a member’s benefit plan, the Participation Agreement or benefit plan information should be used. 
  • Section: Utilization Management Program 
    • Language additions, revisions, and removal of outdated information 
    • Updated the process instructions under the Precertification & Concurrent Review/Discharge Planning sub section 
  • Section: Tips to Avoid Delays
    • Updated wording and tips
  • Section: National Provider Identifier (NPI)
    • Added information about types of NPI’s
  • Section: Provider Audit and SIU Process
    • Language additions, revisions, and removal of outdated information 
    • Removed DRG coding audit information
  • Section: Accreditation
    • Updated language related to accreditation
  • Section: Claim Corrections: Criteria 
    • Added information regarding purged claims
  • Section: Reimbursement & Billing Guidelines
    • Sub section: Inpatient Swing bed and Inpatient Transitional Care Unit– Hospital Billing were combined due to the similar process. New section is called Inpatient Rehabilitation, Swing Bed and Transitional Care Unit Per-Diem services‑Hospital Billing

Contact our Medicaid Expansion Provider Service Center at 1-800-368-2312.