Serving North Dakota Medicaid Members
Welcome to ND Medicaid's Provider Education and training webpage. Check back soon for exciting new trainings coming in 2025.
Thank you for being a ND Medicaid provider serving Medicaid members.
Training Materials and Resources
| ACIP | Advising Committee on Immunization Practices |
| ADRC | Aging and Disability Resource Center |
| AETS | Adult Education Transitional Services |
| AFFC | Adult Family Foster Care |
| APC | Ambulatory Payment Classification Code unique identifier |
| ASP | Average Sales Price |
| CAHPS | Consumer Assessment of Healthcare Providers and Systems |
| CERT | Comprehensive Error Rate Testing |
| CFS | Children and Family Services |
| CHIP | Children's Health Insurance Program |
| CFR | Code of Federal Regulations |
| CMS | Centers for Medicare & Medicaid Services |
| CMS 64 | Medicaid report |
| CMS21 | SCHIP report |
| CMSO | Center for Medicaid and State Operations |
| CNS | Clinical Nurse Specialist |
| COB | Coordination of Benefits |
| CPT | Current Procedural Terminology |
| CSP | Coordinated Services Program (recipient lock in program) |
| CSR | Continued Stay Review |
| CVS | Comma separated values |
| dataprobe | reporting software that our SURS analysts use |
| DBA | Doing Business As |
| DD | Developmental Disabilities |
| DDC | Database & Documentation Contractor |
| DHS | Department of Human Services |
| DME | Durable Medical Equipment |
| DMEOPS | Durable Medical Equipment, Orthotics, Prosthetics & Supplies |
| DOB | Date of birth |
| DP | (perform DP review) |
| DPI | Department of Public Instruction |
| DRG | Diagnostic related groups |
| DSH | Disproportionate Share Hospital |
| E H R | Electronic Health Records |
| E/M | Evaluation and Management |
| EA | Economic Assistance |
| EMAR | Enterprise Management and Administrative Reporting system |
| EPHI | Electronic private health information |
| EPLS | Excluded Parties List System (being replaced by SAM |
| EPSDT | Early Periodic Screening Diagnostic and Testing |
| EQR | External Quality Review |
| ERRP | Error Rate Reduction Plan |
| ESRD | End Stage Renal Disease |
| FFATA | Federal Funding Accountability and Transparency Act |
| FFP | Federal Financial Participation |
| FFS | Fee for service |
| FIPS | Federal Information Processing Standards |
| FMAP | Federal Medicaid Assitance Percentage |
| FP | Fixed payment |
| FPL | Federal Poverty Level |
| FQHC | Federally Qualified Health Center |
| FS | Family Subsidy |
| FSS | Family Support Services |
| FTP | File transfer protocol |
| GI | General Information |
| HCBS | Home and Community Based Service |
| HCPCS | Healthcare Common Procedure Coding System |
| HCFA | Health Care Financing Administration |
| HEDIS | Healthcare Effectiveness Data and Information Set |
| HHS | Health and Human Services |
| HIPP | Health Insurance Premium Payments |
| HPMP | Hospital Payment Monitoring Program |
| HSC | Human Service Center |
| ICF | Intermediate Care Facility |
| ICF/MR | Intermediate Care Facility/Mentally Retarded |
| ICN | Internal control number |
| IDEA | Individuals with Disabilities Education Act |
| I H S | Indian Health Services |
| IM | Interoffice Memorandum |
| IPIA | Improper Payment Information Act |
| ISLA | Individualized Supported Living Arrangement |
| ISP | Individualized Service Plan |
| IT | Information Technology |
| LAC | Licensed Addiction Counselor |
| LEIE | List of Excluded Individuals/Entities |
| LICSW | Licensed Independent Clinical Social Worker |
| LSW | Licensed Social Worker |
| MA | Medical Assistance |
| MC | Managed Care |
| MCO | Managed Care Organization |
| MDS | Minimum Data Set |
| MEQC | Medicaid Eligibility Quality Control |
| MMAC | Medicaid Medical Advisory Committee |
| MMIS | Medicaid Management Information System |
| MR | Mentally retarded |
| MSLA | Minimally Supervised Living Arrangement |
| MTM | Medication Therapy Management |
| MTMP | Medication Therapy Management Program |
| MTMS | Medication Therapy Management System |
| NASHP | National Academy for State Health Policy |
| NCCI | National Correct Code Initiative |
| NDC | National Drug Codes |
| NDMA | North Dakota Medicaid |
| NDMA | North Dakota Medical Association |
| NEMT | Non-emergent medical transportation |
| NET | Non-emergency transportation |
| OAR | Option Adjustment Request |
| OIG | Office of Inspector General |
| OGC | Office of General Counsel |
| OMB | Office of Management and Budget |
| OOS | Out of State |
| PA | Prior Authorization |
| PA | Physician Assistant |
| PACE | Program of All- inclusive Care for the Elderly |
| PBQI | Process Based Quality Improvement |
| PCP | Primary Care Provider |
| PCMP | Prescription Drug Monitoring Program |
| PDL | Preferred drug list |
| PECOS | Provider Enrollment, Chain and Ownership System |
| PERM | Payment Error Rate Measurement |
| PERT | PERM Eligibility Review Tracking |
| PETT | PERM Eligibility Track Tool |
| PHI | Personal Health information |
| PHP | Partial Hospitalization Program |
| PI | Program Integrity |
| PIHP | Prepaid Inpatient Health Plan |
| PII | Personally identifiable information |
| PIP | Personal Injury Protection |
| PIP | Performance Improvement Plan |
| PMPM | Per member per month |
| PRTF | Psychiatric Residential Treatment Facility |
| POC | Point of contact |
| PTAR | Prior Treatment Authorization Request |
| QC | Quality Control |
| QSP | Qualified Service Provider |
| RA | Remittance Advice |
| RAC | Recovery Audit Contractor |
| RC | Review Contractor (Specific to PERM) |
| RCCF | Residential Child Care Facility |
| RCR | Real Choice Rebalancing |
| RDARS | Report Data Archive and Retrieval System |
| REOMB | Recipient Explanation of Medical Benefits |
| RHC | Rural health clinic |
| RL | Recipient Liability |
| PRO | Professional Review Organization |
| SA | Service Authorization/Prior Authorization |
| SAM | System for Award Management (for screening providers) |
| sampling unit | smallest individually priced unit paid for a beneficiary |
| SC | Special consideration |
| SC | Statistical Contractor |
| SCHIP | State Children's Health Insurance Program |
| SFTP | Secure File Transfer Protocol |
| SLA | Supported Living Arrangement |
| SMA | State Medicaid Agency |
| SMERF | State Medicaid Error Rate Findings |
| SNAP | Supplemental Nutritional Assistance Program |
| SNF | Skilled Nursing Facility |
| SPA | State Plan Amendment |
| SPED | Service Payments for the Elderly and Disabled |
| SPIA | State Program Integrity Assessment |
| SUD | Sampling Units Disposition |
| SUR | Surveillance Utilization Review |
| SURS | Surveillance Utilization Review System |
| TAG | Technical Advisory Group |
| TANF | Temporary Assistance for Needy Families |
| TCLF | Transitional Community Living Facility |
| TCN | Transaction Control Number/Claim Number |
| TECS | Technical Eligibility Computer System |
| TOB | Type of Bill codes |
| TPA | Third Party Administrator |
| TPA | Trading Party Agreement |
| TPL | Third Party Liability |
| UR | Utilization Review |
| VFC | Vaccine for Children |
| XIX | Medicaid expenditures (title 19) |
| XXI | SCHIP expenditures (now known as CHIP, title 21) |
Questions? Contact Us
The North Dakota Medicaid Call Center's hours of operation are Monday-Friday from 8 a.m. to 5 p.m. CT.
Email: mmisinfo@nd.gov
Toll-Free: (877) 328-7098, 711 (TTY)
For questions regarding specific training topics or training materials, contact our provider education team.