Medicaid Expansion: Out-of-Network Requests through Availity

Blue Cross Blue Shield of North Dakota (BCBSND) is informing providers Medicaid Expansion referrals are being entered into the Availity provider portal incorrectly. Requests for out-of-network services need to be submitted as an authorization not a referral. At this time the referral function in Availity is only used for the commercial BCBSND line of business. Requests for out-of-network services for Medicaid Expansion members are approved or denied by BCBSND.

Any providers who submitted a referral versus an authorization for an out-of-network service, would need to re-enter the information into the Availity provider portal as an authorization.

We apologize for any inconvenience this may have caused. For additional questions, contact our BCBSND Medicaid Expansion Provider Service Center at 1-833-777-5779.