Provider Audit Work Plan Audits

As part of the 2023 Provider Audit Work Plan, Blue Cross Blue Shield of North Dakota (BCBSND) is informing providers that the Special Investigation Unit (SIU) and Provider Audit department is auditing Evaluation and Management (E/M) services billed with additional services, and high incidence of modifier usage through the second quarter. Providers identified with outlier billing patterns based on submitted claims data may be asked to submit records and documentation as part of this audit. 

For additional questions, refer to our BCBSND Customer Contact Center at 1-800-368-2312 or BCBSND Medicaid Expansion Customer Contact Center at 1-833-777-5779.