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Medicaid Expansion: Approved Precertification Prior to January 1, 2022

Blue Cross Blue Shield of North Dakota (BCBSND) Medicaid Expansion providers who have already received an approved Medicaid Expansion precertification for members prior to January 1, 2022, will not require a new precertification. This includes all planned elective procedures occurring in 2022 during the administration change from Sanford Health Plan to BCBSND. BCBSND will honor the previous precertification approvals into 2022.

BCBSND will allow 30-days of continuity of care for members admitted inpatient or who received continued care services prior to January 1, 2022. During this period, providers will need to obtain a new approved precertification, for services which are needed past January 30, 2022. Authorization can be obtained through the Availity provider portal precertification approval process. If you do not have Availity provider portal access, please register at the attached link Availity Essentials Portal Registration.

Note that certain precertification requirements may have changed due to the administrative change. Review the Medicaid Expansion precertification requirements at Precertification for Medicaid Expansion. Services or supplies which require precertification that were not precertified prior to the service being completed or received will become provider liable effective January 31, 2022. For additional questions, contact our BCBSND Medicaid Expansion Provider Service Center at 1-833-777-5779.