Quarterly Provider Insights: June 2026

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.

Provider Message

Summer Provider Collaboration Sessions Have Ended

The Provider Engagement Team extends its gratitude to all providers who participated in the 2026 Summer Provider Collaboration sessions. With 44 providers attending our in-person sessions in Minot, Bismarck, Fargo and Grand Forks and over 70 joining our virtual sessions, we truly appreciated the opportunity to connect with each of you, share updates, answer questions, and hear your valuable insights.

We are committed to strengthening our partnerships and hope that this collaboration session was both informative and beneficial. If you have any questions or comments, please feel free to reach out to us at prov.partners@bcbsnd.com.

News and Announcements

Discontinuation of Arkos Health Care Management Support for Medicaid Expansion and Nextblue Members

The transition of care management services from Arkos Health to internal support teams has concluded. It is important to note there is no gap in care services, and our teams will work diligently to ensure members get the support they need, while focusing on maintaining continuity and stability.

• For Medicaid Expansion, the transition will go from Arkos Health to the BCBSND Care Management team.
  • Questions can be directed to the Medicaid Expansion call center at 833‑777‑5779.
• For Nextblue, the transition will go from Arkos Health to the NextBlue of North Dakota team.
  • Questions can be directed to the NextBlue call center at 844‑753‑8038 (for members) or 844‑753‑8039 (for providers).

Educational

Provider Manual Update Notification

Blue Cross Blue Shield of North Dakota (BCBSND) would like to inform providers of the following updates made to the BCBSND Commercial and Medicaid Expansion (ME) provider manuals.

We always encourage our providers to review our website and provider manuals to answer questions or when looking for guidance.

Updated sections for the Commercial and Medicaid Expansion manuals:

• Access and Availability Standards
  • Removed standards for obstetrics and gynecology
  • Added follow up time frame for routine appointments

Provider Directory Validation Process

Is your provider's directory information up to date?

Members rely on the provider directory to choose in‑network providers for services. To ensure accuracy, providers must validate their information every 90 days through the Availity Essentials Provider Portal and submit updates using the Directory Maintenance form.

For providers unfamiliar with the validation process, it can be found outlined on www.BCBSND.com website here. 

Provider directory information includes:

• Name and any group affiliation
• Street address(es)
• Telephone number(s)
• Website
• Specialty
• Medical school attended, graduation year and residency
• Board certifications
• Gender
• Languages spoken
• Whether the provider will accept new patients
• Whether the provider’s office/facility has accommodations for people with physical disabilities, including offices, exam room(s) and equipment

Promptly notify BCBSND Provider Networks via the directory maintenance form, if:  

• Any contact information changes, including address, phone number, fax number or messaging options
• New providers join your practice  
• Providers leave your practice, including through retirement or termination  
• A business or practice closes or merges  
• Your National Provider Identifier (NPI) number changes  
• Your status regarding accepting new patients changes  
• The list of languages spoken in the office changes  
• Patient gender or age restrictions change  
• A provider’s specialty or board certification has changed for any active service location  
• A new tax ID number is obtained  
• The address for a 1099 form changes  

To ensure our directory is accurate, we will be expanding our review of our provider directory maintenance to a monthly review. BCBSND will be sampling BCBSND Medicaid Expansion providers selected at random.

Provider directory information may be suppressed, if:

• Validation attestations are not completed
• No Medicaid Expansion claims are submitted within a twelve (12) month time period.
  • If a provider does submit claim(s) again, the Update Provider Information form will need to be completed. Providers can fill in the free text area that claim submissions have been done and would like to be added back into the directory.    

Note: In addition to removal from the directory for any Medicaid Expanison provider removed from the directory we will dis-enroll provider from the Medicaid Expansion Network at 12 months. Notification will be sent to provider 3 months prior to dis-enrollment for notification.

Ensure your staff are aware of the provider directory maintenance process, when applicable.

Quick Tip

• If your office uses voicemail for incoming calls, it is important to include a clear return call timeframe so patients know when to expect follow up.

Questions?
For assistance follow the Provider Directory Validation process.

Need help with Availity Essentials or login?

• Call Availity Client Services at 800-282-4548
  

For questions about the Provider Directory Validation process, that are not addressed in the process guide or other resources, email Provider Credentialing at prov.net@bcbsnd.com.