Where to Find Health Care

Handbook Content

Terms and Meanings

Some terms that we use in this chapter may not be familiar. These terms and their meanings are listed below.

  • Alignment: To straighten the spine.
  • Approved/Authorized: The decision Medicaid makes to pay for a service.
  • Assistance: Help.
  • Durable Medical Equipment: The decision Medicaid makes to pay for and allow you to have a service.
  • Facility: A health care building or practice.
  • Immunization: The act of building a resistance to diseases.
  • Individuals: People.
  • Long-Term Care: Cares for elderly or disabled members to get in their homes, communities, or facilities.
    Optometrist: A specialist who takes care of the primary health of your eyes.
  • Prescription: An order from your provider for medications, equipment, testing, or supplies.
  • Primary Care Provider: Your main health care professional who maintains your good health and cares for your basic health needs by giving vaccines, finding disease, and offering medication or treatment for conditions or symptoms.
  • Provider: A doctor, nurse, therapist, or another qualified health care professional
  • Referral: A written order from your primary care doctor for you to see a specialist or get certain medical services.
  • Required: Must have.
  • Services: Care, treatments, testing, checkups, equipment, supplies, and other ways your health care providers help you stay healthy.
  • Transportation: Being given a ride.

North Dakota is made of larger cities, rural communities, and Tribal lands. Access to health care may look different depending on where you live. In this chapter, we explain several different medical facility types, so you understand some different options available to you. 

Ambulatory Surgical Centers

Ambulatory surgical centers are stand-alone facilities that are usually not connected to a hospital. These facilities are supplied with everything needed for a minor surgery. Your surgical center must be enrolled with Medicaid and may need an authorization to have your costs covered. Covered services from an ambulatory surgical center include:

  • Use of the facility
  • Nursing and technician services
  • Medication, surgical dressings, supplies, splints, casts, and equipment for a surgical procedure
  • Urinary supplies
  • Administrative, record keeping, and housekeeping services
  • Blood, plasma, and platelets
  • Anesthetic and supplies

Some charges may be billed from a separate facility or provider and may be covered by Medicaid such as:

  • Physician, anesthesiologist, and certified registered nurse anesthetists’ services
  • Laboratory, x-ray, or diagnostic procedures not directly related to the surgery
  • Prosthetic devices
  • Ambulance services
  • Durable medical equipment
  • Pathology services

You can find a list of North Dakota ambulatory surgical centers on our website.

Basic Care Facilities

Basic care facilities are residences, like apartments, where people get help with health, social, and personal cares. Medicaid may require certain cares to be authorized. A case manager can help you organize your ability to stay and your coverage for services.

You can find a list of North Dakota basic care facilities on our website.

Community Health Centers

Community Health Centers (CHC) are nonprofit, community-driven clinics that provide care to rural and urban communities. Anyone can be seen at a CHC even if you cannot pay. You can be seen with any insurance or no insurance. North Dakota CHCs have 22 delivery sites in 20 communities. Some services that may be offered include:

  • Basic health care
  • Behavioral health
  • Dental
  • Diagnose and treat disease
  • Manage chronic health conditions
  • Manage diabetes
  • Medication-assisted treatment
  • Primary and preventive care
  • Promoting healthy living
  • Substance Use Disorder treatment
  • Vision

Your CHC may be able to treat you at different locations such as:

  • At the CHC facility
  • By virtual appointment
  • At your home
  • Community-based locations (homeless shelter, low-income housing units, schools)

Talk to your local CHC to find out which services are offered in your area. You can find a list of CHCs on our website.

Hospitals

A hospital can offer you inpatient health care while you stay for treatment. They also offer outpatient health care for same-day treatment. Medicaid may need to approve in-state hospital services and will need to approve all out-of-state hospital services. Your local hospital may have emergency room services, behavioral health-related care, a walk-clinic or urgent care, provider offices, laboratories, diagnostic services, or pharmacies.

The codes before the hospital types listed below can help you navigate our list of North Dakota hospitals. Different types of hospitals include:

  • CAH: Critical Access (Smaller, rural hospital).
  • ACU: General Acute or Primary Care (Often offers surgery and treatment for severe, short-term symptoms).
  • Indian Health Services (Offers health care to Native American Tribal members).
  • HOSP-LT: Long-Term Acute Care (Offers longer stays to patients).
  • PSY: Psychiatric (Specialized in the treatment mental health conditions).
  • RHB: Rehab (Specialized in the care of conditions that affect muscles, nerves, and bones).
  • TH: Transplant (Focuses on transferring organs from donor to recipient).

You can find a list of North Dakota hospitals on our website.

Human Service Centers

Regional human service centers (HSC) provide services for behavioral health and substance use disorders. Your HSC may offer medication management, group and individual therapy, assessments, and more. HSCs offer walk-in clinic hours and appointments. HSCs are a gateway to home and community-based services in your area. 

Talk to your local human service center to find out which services are offered in your area. You can find a list of human service centers on our website. 

IHS/Tribal Facilities

Indian Health Services (IHS) is a federal agency that is responsible for American Indian and Alaskan Native health care. IHS is also a health care provider. IHS/Tribal health care facilities are specifically designed to offer a range of health care services to their tribal members, and they work with Medicaid. Your IHS/Tribal facility may offer:

  • Basic health care
  • Dental
  • Vision
  • Diabetes management
  • Podiatry
  • Behavioral health

You can find an IHS/Tribal facility on the Indian Health Services website.

You can learn more about IHS/Tribal health in the Tribal Health and Indian Health Services chapter of this handbook.

Intermediate Care Facilities

Intermediate Care Facilities (ICF) are a primary residence for members with intellectual or developmental disabilities. Medicaid allows a set number of days for you to spend away from the facility. An ICF may offer supports in activities of daily living, help taking medications, counseling, rehab services, and other supports. You must meet the required level of care for Medicaid to approve these services.

Local Public Health Units

Local public health units (PHU) offer a variety of services including our services that are available for children through age 20. There are 28 local PHUs throughout North Dakota. Services vary per PHU. Some services that may be offered include:

  • Allergen immunotherapy
  • Blood lead screening
  • Clinic visit
  • Diabetes prevention
  • Ear cleaning
  • Emotional or behavioral assessment
  • Fluoride varnish application (ages 6 months through 20 years)
  • Child health screenings, diagnoses, and treatment
  • Hearing screening
  • High blood pressure screening
  • Home health visits
  • Immunizations
  • Injury prevention screening
  • Laboratory services
  • Medical nutrition therapy
  • Medication management
  • Middle ear testing
  • Naloxone supplies
  • Nursing assessment and services
  • Routine foot care
  • Sign language and interpretive services
  • Tobacco use prevention
  • Vital sign checks

Talk to your local PHU to find out which services are offered in your area. You can find a list of North Dakota local public health units on our website.

Psychiatric Residential Treatment Facilities

Psychiatric Residential Treatment Facilities (PRTF) are places where members can live and get care for their mental health. A provider oversees all your care at these facilities. You must meet the certificate of need to get this service. Medicaid needs to approve these services. This service is for members under age 21. 

You can find a list of North Dakota psychiatric residential treatment facilities on our website.

Rural Health Clinics

Rural health clinics (RHC) offer health care services to communities that cannot easily access hospitals and provider offices because of location. Your rural health clinic may offer: 

  • Clinic visit
  • Home visit
  • Immunizations
  • Primary care services
  • Residential facility visit
  • Telehealth services

Providers that can offer your health care at a rural health clinic are:

  • Clinical (Licensed) Psychologist
  • Licensed Clinical Social Worker
  • Nurse Midwife
  • Nurse Practitioner
  • Physician
  • Physician’s Assistant
  • Visiting Nurse

Talk to your local RHC to find out which services are offered in your area. You can find a list of North Dakota rural health clinics on our website.

Skilled Nursing Facilities

Skilled nursing facilities are a primary residence for members to get the daily medical care they need. Medicaid allows a set number of days for you to spend away from the facility. Your cares may include medication management, wound care, bathing, feeding, social activities, and other activities of daily living. You must meet the level of care needed for Medicaid to approve your services. Some services that may be offered include:

  • Equipment
  • Non-emergency transportation
  • Nonprescription medications
  • Nursing supplies
  • Room and board
  • Supplies
  • Therapies

You can find a list of North Dakota skilled nursing facilities on our website. 

Swing Bed Facilities

Swing bed services help a member move directly from a hospital setting to long-term care such as a skilled nursing facility. You must meet the level of care for Medicaid to approve these services. Some services that may be offered include:

  • Equipment
  • Nursing supplies
  • Nonprescription medications
  • Room and board
  • Supplies
  • Therapies
  • Transportation

You can learn more about long-term care services and swing bed facilities on our website.

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