Here is what you need to know about enrolling as a 1915(i) provider.
Complete steps 1-4 below.
Group enrollment must happen before you can add (affiliate) individual service providers to your group. Individual 1915(i) provider enrollment will not be approved without an affiliation to an existing, approved group.
Changing a service provider's group affiliation
Group providers may affiliate individual service providers currently enrolled under a different agency/group by submitting the SFN 1330 Request to Add an Affiliation Form linked below under the "Enrollment Resources" tab.
Removing a service provider from your group
Individual providers may be affiliated with multiple group providers. If an individual leaves employment with an agency, the agency should complete the SFN 1331 Termination Form linked below under the "Enrollment Resources" tab.
Complete steps 1-3 below. Individual 1915(i) provider enrollment will not be approved without an affiliation to an existing, approved group.
Questions? Need help?
We have enrollment specialists standing by to assist you between 8 a.m. - 5 p.m. CT, Monday-Friday.
Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment
PO Box 6055
Fargo, ND 58108-6055
Email: NDMedicaidEnrollment@noridian.com
Phone: Toll-free (877) 328-7098 or (701) 328-7098, option 1
After-hours voicemail available.
Fax: (701) 433-5956
Obtain a National Provider Identifier (NPI) number.
- Create an NPI number here
- Find the Group and Individual Taxonomy Codes Here: Service Codes and Limits
- NPI Application Instructions
If a provider has previously been issued an NPI, they will not apply for a new one, rather they will need to ensure their existing NPI is updated to reflect the proper taxonomy codes for the services they will be enrolling to provide.
For NPI login assistance, contact the Identity & Access System (I&A):
- Telephone at (866) 484-8049
- Email at eussupport@cgi.com
For assistance once logged in to the NPI system, contact the NPI Enumerator (available M-F 9 a.m. - 5 p.m. ET):
- Telephone at (800) 465-3203 (TTY (800) 692-2326)
- Email at customerservice@npienumerator.com
Find out if an NPI has been previously issued to an individual or organization here: Search the NPI Directory.
Provider Enrollment Online Application Guide
Find the Group and Individual Taxonomy Codes Here: Service Codes and Limits
Contact the ND Medicaid Provider Relations Call Center with questions or problems with the online application at (701) 328-7098, toll-free at (877) 328-7098, 711 (TTY), or by emailing mmisinfo@nd.gov.
- Obtain required forms by clicking on the links in the documents below.
- Complete the required forms
- Sign any forms requiring a signature
- Gather required documents from your files (such as licenses, federal tax letters, bank letters, etc.) – These vary depending on the type of service/services you will be providing
- Submit all documents and forms to Provider Enrollment via email to NDMedicaidEnrollment@noridian.com, or by fax to (701) 433-5956.
- Please refer to the Individual 1915(i) Provider Screening Policy for more information about background check requirements
Complete registration for the MCO Portal using the following link: MCO Information
Request a BCBSND contract for 1915(i) services by emailing: ProviderContracting@bcbsnd.com
Once you are enrolled and have received verification of enrollment as an agency (group) provider, complete the below tasks to get added to the 1915(i) Provider List.
1 | Review 1915(i) Provider Guidance and Policies |
2 | Draft and implement agency-specific 1915(i) policies and procedures for quality assurance. Ensure staff are trained on these and that they reviewed and updated as needed.
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2 | Verify Individual Providers meet provider qualifications for services - i.e., do they have necessary training/certifications/etc.? Provider qualifications are listed in service policies. |
3 | Ensure Therap accounts are set up. Email nd1915i@nd.gov with the following information for your agency and internal Therap administrator (this person will add individual service providers into Therap)
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4 | Attend a Therap Administration Orientation/Overview session Therap will reach out to your designated administrator. |
5 | Email nd1915i@nd.gov with the subject line "Add to Provider List" along with the following information:
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- More information on Affiliations
- Affiliation Form
- More information on Terminations
- Termination Form
- Add a Taxonomy Form
- Find the Group and Individual Taxonomy Numbers and the Service Codes you need here: Service Limits and Codes