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Medicaid Expansion Pre-Service Appeal Requests for Members-Revised

Blue Cross Blue Shield of North Dakota (BCBSND) is informing Medicaid Expansion providers that pre-service appeals can only be initiated by the member or their authorized representative. If a provider files a pre-service appeal request on behalf of a Medicaid Expansion member, they assume responsibility to act on behalf of the member. Pre-Service appeals will no longer require an Authorization to Release Information (ARI) form when submitted by the provider on behalf of the member, as previously stated.

Additional Medicaid Expansion appeal information can be found on our Medicaid Expansion provider website at Appeals Process for Medicaid Expansion. The Medicaid Expansion provider manual will also be updated with this clarification within the next 60 days.

For additional questions, contact the BCBSND Medicaid Expansion Provider Service Center at 1-833-777-5779.