Quarterly Provider Insights shares information to our provider community in the third month of each quarter.
Quarterly Provider Insights will provide information regarding a company message, news and announcements, educational topics and miscellaneous updates.
Message from Provider Educator: Kimberly Behrens
Over the past year, our Provider Engagement team has shared stories about our Caring Foundation through HealthCare News. This year, during our Spring Provider Collaboration sessions across North Dakota, our Provider Partners team shared information about the Caring Foundation and received excellent feedback from our Provider community. A few of the comments we received were: “I would like to hear more about the Caring Foundation and its ongoing impacts and changes,” “I was unaware of the Caring Foundation,” and “I know someone who could benefit from a program like that.”
For more than 35 years, the BCBSND Caring Foundation has supported sustainable and innovative efforts by collaborating with organizations across North Dakota. Our focus areas include behavioral health, social determinants of health, and preventive health.
The Caring Foundation is one of the reasons I love working for BCBSND. Over the years, I have had the privilege of collaborating with Amber Blomberg, Director of Community Engagement, and her dedicated team. Through this collaboration, I have witnessed firsthand the profound impact our foundation is making across North Dakota.
Health and well-being are essential building blocks to personal fulfillment, thriving communities, and a stronger state. By joining forces with change makers, innovators, and problem solvers, we work to tackle the root causes of health issues, ensuring a healthier future for all.
There is a chance that our foundation may be able to assist in making a difference in your community. If you want to learn more about our available grants, our impact, community involvement and sponsorship, environmental, social and governance, and our mission, visit our Caring Foundation webpage.
I am proud that our Caring Foundation aligns with our company mission: “Improving the Health and Well-being of North Dakotans and our Communities”.
Let’s Create an Impact Together.
Sincerely:
Kimberly
Our Caring Foundation is excited to share that we are teaming up this year again to improve access to mental health services again this summer by partnering with the American Foundation for Suicide Prevention (AFSP) North Dakota chapter to raise awareness about mental health resources.
For every strikeout thrown by the home team in July by the Minot Hot Tots, Bismarck Larks, Minot Honeybees, Badlands Big Sticks and FM RedHawks, the Caring Foundation will donate $50 to AFSP.
Help us root for these teams and keep an eye on the dollars scored here.
Effective documentation is essential in healthcare, ensuring quality patient care, compliance with standards, and accurate reimbursement. When documenting time-based services, correct documentation is crucial for reflecting the duration of services and supporting insurance claims.
Blue Cross Blue Shield of North Dakota (BCBSND) would like to emphasize that documentation must clearly support the medical necessity of services and must fully substantiate the CPT, HCPCS, and ICD-10 codes submitted on claims. We would also like to emphasize that when using time, BCBSND prefers providers to use a start time/stop time.
Time documentation ensures:
Proper time documentation ensures compliance with BCBSND’s policies and aids in reimbursement. Providers should follow guidelines and adopt best practices to improve documentation accuracy.
For more details, refer to the BCBSND provider manual and stay updated with policy changes.
Effective June 1, 2025, practitioner applications will now be done through the Council for Affordable Quality Healthcare (CAQH) Provider Data Portal and will no longer be accepted via paper.
Highlights of utilizing CAQH:
We have seen an increase in Providers registering for CAQH and thank Providers who have taken the time to register.
Questions?
Looking for more information or if you have not had the opportunity to register, please refer to the Practitioner Credentialing Process Change Notification HealthCare News article.
As outlined in our June 12, 2025 HealthCare News article Risk Adjustment Data Validation (RADV) and The Department of Health and Human Services (DHHS) Medical Records Request we have been notified by The Department of Health and Human Services (HHS) that we are required to participate in an Initial Validation Audit (IVA) for a sample of members both on and off the Health Insurance Exchange (HIX). This audit is not specific to you or your practice and is not designed to monitor your practice, and your billing or coding patterns.
What You Need to Know About Chart Fees
Based on the government mandated audit, it is a provider’s obligation to provide medical records or obtain records from your vendor and submit the requested medical records with no charge to Cognisight or Virtix Health. Please do NOT mail, fax, or email any invoice/pre-payment invoice requests. Thank you for your cooperation.
This audit does not apply to the North Dakota Medicaid Expansion program.
Questions?
If you have any questions and/or prefer to provide access to medical records via electronic medical record (EMR) or secure file transfer, please contact:
Thank you in advance for your prompt response.
Is your provider's directory information up to date?
Our members (your patients) rely on the information listed in the provider directory to select in-network providers for health care services. Validating your information every 90 days ensures our provider directory displays accurate information.
Blue Cross Blue Shield of North Dakota (BCBSND) asks our provider community to validate their directory information through the Availity Essentials Provider Portal and continue to submit changes through the Availity Essentials directory maintenance form. Making these timely changes and validating information every 90 days allows the directory to be the most accurate. This also assists BCBSND in meeting the No Suprise Act (NSA) Federal Mandate and Utilization Review Accreditation Commission (URAC) requirements.
Your provider's information may be suppressed from the directory if validations are not attested at least once per year. Removal from the directory does not change participation status.
Questions?
For assistance follow the Provider Directory Validation process.
Need help with Availity Essentials or login?
For questions about the Provider Directory Validation process, email Provider Credentialing at prov.net@bcbsnd.com.
