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
Faxed documents are no longer accepted, please send documents 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 (July 1, 2023)
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QSP Rural Differential Rates (July 1, 2023)
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QSP Rates (October 2022)
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QSP Rural Differential Rates (July 1, 2022)
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.
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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 (829 kb pdf) Forms Packet (2.95mb pdf) (June 2023)
- Agency Provider (1.04mb pdf) (April 2023) Form Packet (1.1mb pdf (June 2023)
- Adult Foster Care Provider (AFC) (1mb pdf) Form Packet (2.50mb pdf) (May 2023)
- Agency Foster Home for Adults Provider (AFHA) (914kb pdf) Form Packet (2.94mb pdf) (April 2022)
Informational packet for NEW QSPs (330kb pdf) (March 7, 2023)
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
- Online Information
- 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: Multigenerational Plan for Aging - Job Service North Dakota retirement webinar (April 27, 2023)
- 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) (May 2023) Form Packet (June 2023)
Family Personal Care Provider (June 2023) Forms Packet (June 2023)