1915(i) Provider Guidance and Policies

General Provider Policies

1915(i) Services

1915i Eligibility Policy

Conflict of Interest

Provider Enrollment Screening

Provider Requirements (including documentation requirements)

Service Authorizations

Telehealth (Remote Support)

Grievance Policy

Care Coordination Policy and Forms

Care Coordination Policy

Meeting Attendee Signatures

Member and Care Coordinator Signatures & Acknowledgements

Member Rights and Responsibilities

Member Rights and Responsibilities - EXPANSION MEMBERS

Multi-Party Authorization to Disclose Information (Release of Information)

Service Policies

Benefits Planning

Community Transition

Family Peer Support

Housing Support

Non-Medical Transportation

Peer Support

Prevocational Training

Respite

Supported Education

Supported Employment

Training and Support for Unpaid Caregivers

Billing for Services Rendered on, or before, December 31, 2025 will be done in MMIS or Availity

Billing & Claims Guidance

Link to Payer Spaces webpage in Availity: Document Title "1915(i) Medicaid Expansion Providers Only- Availity Provider Resource Guide"

Link to Payer Spaces webpage in Availity: 1915(i) Medicaid Expansion Providers - How To Provider Resources Video

VIDEO: How to submit a 1915(i) claim in MMIS

MMIS 1915(i) Web Portal Instructions

MMIS Claim Replacement/Void Instructions

MMIS How to Add Claims Attachments

Checking a Member's Eligibility in MMIS

Medicaid Check Write Dates

Place of Service Codes

Service Information - limits, codes, taxonomies, requirements Updated November 2024

Claims

Home and Community-Based Services (HCBS) Resources

HCBS Settings Requirements

Initial 1915(i) HCBS Settings Review

HCBS Settings Assessment Guide

HCBS Heightened Scrutiny Visit Form

Member Discharge

Transfer and Termination of Member Services

Discharge Letter Template

Reports

Individual Provider Review Report

Provider Agency Review Report

WHODAS Guidance & Resources

WHODAS Administration Training Requirements

Needs Based Eligibility WHODAS and DLA Assessments Policy

WHODAS 2.0 Manual

WHODAS Training

WHODAS Administration and Scoring Presentation Slides

WHODAS 2.0 Interview Assessment

WHODAS Complex Scoring Sheet

WHODAS Flashcard 1

WHODAS Flashcard 2

WHODAS 2.0 Proxy Assessment

Billing for Services Rendered on, or after, January 1, 2026 will be done in Therap

Therap

Therap's Login Page

Click here to access Therap's North Dakota 1915(i) Resources Page.

Plan of Care Creation Guide

Referral Guide

Quarterly/Interim Reviews & Individual Plan Agendas

Updating Pre-Auths on a Plan of Care

Change Form Guide

Adding Contacts & Guardian Information

How to Create Case Notes

How to look up Member Information

Discharging Members

Creating and Assigning Sites and Programs

Saving Documents in Member's Therap Oversight Account

Click here to access Therap's General Event Reports (GER) guide

Community Transition Service Support Materials

Veridian Fiscal Solutions

1915(i) Community Transition Plan of Care and Request for Funds (only for Community Transition Service)

DRAFT POLICIES

DRAFT Claims Policy