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.
To enroll as a QSP, contact Noridian Healthcare Solutions.
Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment QSP
PO Box 6055
Fargo, ND 58108-6055
Phone: 701-277-6933
Email: QSPEnrollment@noridian.com
Fax: 701-277-6635
As of April 1, 2023, you may only submit enrollment paperwork by email or mail.
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.
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QSP Rates (October 2022)
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QSP Rural Differential Rates (July 1, 2022)
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.
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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!
- Individual Provider (1mb pdf) Forms Packet (2.95mb pdf) (June 2022)
- Agency Provider (1.04mb pdf) Form Packet (3.06mb pdf) (June 2022)
- Adult Foster Care Provider (AFC) (1mb pdf) Form Packet (2.50mb pdf) (April 2022)
- Agency Foster Home for Adults Provider (AFHA) (914kb pdf) Form Packet (2.94mb pdf) (April 2022)
Informational packet for NEW QSPs (330kb pdf) (March 24, 2020)
Billing Instructions
Paper
- SFN 1730 Paper Billing Instructions - Paper Billing Example
- SFN 1730 Paper Claim Correction Void and Replacement Instructions - Void and Replacement Example
- SFN 1730 HCBS Billing Form (blank)
Online
- MMIS Web Portal Professional Claim Form Submission Instructions (694 kb pdf)
- MMIS Web Portal HCBS/DD QSP Billing Instructions
- FACT SHEET: Internet Browser Compatibility
- MMIS Web Portal HCBS/DD QSP Void and Replacement Instructions
- Benefits of Online Billing - February 2017
- Pay Dates
Claims Questions?
- Claims payments
- Claims submissions
- Prior Authorizations
Documentation Guidelines for Individual Providers
Computer-Based Training
- SFN 1730 HCBS/DD QSP Billing Form - View Computer-Based Training
Contact
Noridian Healthcare Solutions
- Toll-Free: (877) 328-7098, 711 (TTY)
- Phone: (701) 328-7098
- Email: mmisinfo@nd.gov
- WEBINAR Recording: Service Authorizations and Professional Billing in Therap for QSPs Providing Services Not Subject to EVV (Posted Nov. 18, 2020)
- Frequently Asked Questions about EVV (updated Nov. 16, 2020)
- WEBINAR Recording: Electronic Visit Verification System for Aging Services Qualified Service Providers (Fall 2020)
- Therap Electronic Visit Verification System in North Dakota (Website Link)
- PRESENTATION: Electronic Visit Verification System Public Input Meetings (Fall 2019)
- PRESENTATION: Electronic Visit Verification System Public Input Meetings (Spring 2018)
- Instructions on how to get a NPI number (1.90mb pdf) (Posted Dec. 9, 2020)
- Fact Sheet (778 kb pdf)
- Video: Go on-the-job to learn about being a Qualified Service Provider by watching an 18-minute video called "A Realistic Job Preview." (112 MB .wmv)
- QSP Toolkit
- ONLINE TRAINING - Fraud, Waste and Abuse
Newsletters
- Qualified Service Provider Newsletter - March 2019
- Qualified Service Provider Newsletter - March 2018
Various Links
- MMIS Web Portal (submit claims for payment)
- Learn more about the ND Health Enterprise Medicaid Management Information System (MMIS) Web Portal
- Human Service Zone Offices
Outreach/Educational Material
- Print Ad (487kb pdf)
- Poster (4.76Mb pdf)
- Television Ad (5.8Mb mov)
- Critical Incident Reporting Module (ADDED Jan. 10, 2022)
- Critical Incident Reporting Recorded Webinar
- Instructions for reporting a critical incident (Jan. 10, 2022)
- Therap General Event Reporting Forms
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) (609kb pdf) Form Packet (1.88mb pdf) (April 2022)