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Enrolling as a Qualified Service Provider

Qualified Service Providers or QSPs are individuals or agencies that provide services to clients who receive services funded by North Dakota Health and Human Services.

People who qualify for home and community-based services can choose among available qualified service providers that offer competitively priced services.

QSPs are independent contractors that have met certain competency standards required to provide services to eligible clients.

The new QSP enrollment portal is here! Visit the portal now to start your enrollment application.

 

Access the QSP Enrollment Portal

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Enrollment Assistance and Resources

Do you need help understanding or completing the enrollment forms or have questions about how to enroll?

The QSP Hub provides support, educational tools, and training opportunities to walk QSPs and QSP agencies through all stages of the QSP process.

Access the QSP Hub

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QSP Rates
QSP Program Update

Posted 10-17-2023

Claims guidance for when members lose and regain Medicaid eligibility 
On April 1, 2023, North Dakota began verifying coverage for regular Medicaid individuals whose coverage was temporarily extended due to the COVID-19 public health emergency.

Some Medicaid members may lose coverage if they do not return information that is needed to process their renewal.

If members lose and then regain eligibility, QSPs will have 180 days from the date the member’s eligibility was updated to resubmit claims that were previously denied because of no member eligibility.

QSPs can verify member eligibility by:

  1. Logging into ND Health Enterprise MMIS https://mmis.nd.gov/portals/wps/portal/EnterpriseHome. Click on the Member tab, then select “Check Eligibility."
  2. Using the Automated Voice Response System (AVRS); Call (877) 328-7098, Option 1.
  3. Calling the Provider Relations Call Center at (701) 328-7098 or (877) 328-7098.

Posted 6-21-2023

As a QSP you are required to revalidate (renew) your enrollment every five years instead of every two years!

Why revalidate?

Revalidations must be done to maintain QSP enrollment. If you do not revalidate your QSP enrollment, it may result in automatic closure of your QSP enrollment. Payments will be stopped if ND Medicaid does not get your completed revalidation packet by the due date.

How will I know if I need to revalidate?

A notice of revalidation will be sent to you before your QSP enrollment expires. Agency revalidation will be sent by email. All other revalidation information will be sent by mail. It is your responsibility to ensure all forms are correct and returned in a timely manner for processing. 

How do I revalidate?

Revalidations require much of the same paperwork you used for your initial enrollment. You must complete and submit a new forms packet and all required documentation. Some services require additional forms to complete revalidation. Make sure you are using the most current forms version!

Specific changes can be found in the Agency, Individual, Family Home Care and Family Personal Care QSPs handbooks.


Click here for QSP Q&A and other information on COVID-19.

IMPORTANT: QSP drop boxes for paper claims are located to the department's Prairie Hills Plaza building located at 1237 W. Divide Ave. - use Door #2, and the department's main office at the State Capital, 600 E. Boulevard Ave., Judicial Wing - third floor, Bismarck.

NEW: North Dakota QSP Hub - North Dakota’s centralized source of support and information for qualified service providers.

  • Get one-on-one individualized support by email, phone, or video conferencing with enrollment questions, service authorizations, electronic visit verification (Therap), documentation, billing processes, renewals and MORE!

QSP Provider Application User Guides
QSP Handbooks
Once You are Enrolled

Informational packet for NEW QSPs (330kb pdf) (March 7, 2023)

Billing Instructions

Paper

Online

Claims Questions?

  • Claims payments
  • Claims submissions
  • Prior Authorizations

Documentation Guidelines for Individual Providers

 

    Computer-Based Training

    Contact

    Noridian Healthcare Solutions

    • Toll-Free: (877) 328-7098, 711 (TTY)
    • Phone: (701) 328-7098
    • Email: mmisinfo@nd.gov
    Resources

    Newsletters

    Various Links

    Outreach/Educational Material

    Family Home Care or Family Personal Care Enrollment

    This application should not be completed unless you have already been in contact with a case manager or your client has already been approved for this service.

    Family Home Care Provider (FHC) (May 2023) Form Packet (December 2023)

    Family Personal Care Provider (June 2023) Forms Packet (December 2023)

    Explanation of Billing Codes

    When you enroll as a QSP, you choose the services you want to provide. All services have a number called a billing code that is used to submit a claim for payment to Health and Human Services. An explanation of billing codes includes important information about each service, how to document your time and certain requirements for each task. The information also gives you tips for how to bill.

    Click here to view the billing codes.

    Agency Foster Homes for Adults (AFHA)

    Aging Services is responsible for licensing Agency Foster Homes for Adults (AFHA). The purpose of an AFHA is to provide a residential setting where four or fewer Medicaid waiver recipients live together and are receiving Residential Habilitation or Community Support services. All referrals to receive Residential Habilitation or Community Support services in an AFHA must go through the Aging & Disability Resource Link (ADRL) intake process by calling phone #855-462-5465, and then be assigned to a  HCBS case manager to determine eligibility for services in this setting.

    Providers interested in developing an AFHA should contact the ADRL.  This setting can only be licensed to assist Medicaid eligible individuals. An AFHA cannot accept individuals who private pay for services.

    List of providers:

    Prairie Home & Health, Mohall ND                                  prairiehomeandhealth@yahoo.com

    Prudent Home Care, Bismarck & Mandan, ND              coker2991@gmail.com

    Lake Region Corporation, Leeds, ND                               jjacobson@lakeregioncorp.com

    Blessed Homes LLC, Jamestown, ND                               georgeblessing24@gmail.com

    Ebenezer Agency Foster Home, Fargo, ND                     wiltontravers@gmail.com

    Blossom Services Group, Fargo, ND                                info@blossomservicesgroupllc.com

    Shepherd Homes LLC, Fargo, ND                                     shepherdhomesmn@gmail.com

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    Enter your email address and click submit. This will take you to a new page. Scroll down to the Adult and Aging heading and select ND QSP Newsletter. You can also select other topics you'd like to receive updates on.