Provider Enrollment Information

Eligibility

To be eligible for enrollment, a provider must:

• Provide services to at least one North Dakota Medicaid eligible recipient.
• Meet the conditions regulating the specific type of provider, program, and/or service.
• Hold a current license, certification, accreditation, or registration according to North Dakota state laws and regulations.
• Providers must pass the enrollment screening process. 

Application Information

All providers are required to apply for enrollment electronically on the ND Health Enterprise MMIS portal. The exception is Qualified Service Providers.

ND Health Enterprise MMIS Web Portal

All enrollment documentation submitted must include the application tracking number (ATN) from the online enrollment application.

• Select and fill out the entire packet that applies to your provider type and specialty
• Attach the required documents and
• Sign the signature pages for the packet to be considered complete.

You may also use the MMIS web portal to directly enter claims, upload batch transactions, and get real-time access to member eligibility, claims status, remittance advice, payment status and claims history.

Enrollment

Use the following resources to submit both the online and documentation portions of your application. The documentation portion cannot be attached to the online application, so you must submit them to Noridian by email or fax.

Revalidation Information

Revalidations are required to be done for all provider records, regardless of provider type, at least every five years.  

QSPs will receive a revalidation notice through the QSP enrollment portal.

Review the provider revalidation list for providers who have upcoming revalidations.

Past due revalidations are listed here. 

In the event your enrollment is included on any of the 90-day revalidation lists submit the applicable revalidation checklist. 

• Select and fill out the entire packet that applies to your provider type and specialty
• Attach the required documents and
• Sign the signature pages for the packet to be considered complete.

Taxonomy Codes

Taxonomy codes identify a health care provider by the service they provide and area of specialty https://www.cms.gov/Medicare/Provider-Enrollment-and Certification/MedicareProviderSupEnroll/Taxonomy.

Providers are required to submit taxonomy codes when submitting paper or electronic claims to ND Medicaid. This excludes Qualified Service Providers (HCBS claims), transportation claims, and claims submitted by other atypical provider types.

Search for Enrolled Providers

Use this search before completing an application. If a provider is enrolled, do not submit a new application.

Options for Submitting Provider Enrollment Documentation

Electronic Secure Link:

For those providers that wish to send the required documentation via email, you must request access to a secure link by sending an email to NDMedicaidEnrollment@noridian.com. An email will be sent back to you with a link to a secure site to send your documents to the enrollment application.

Fax:

Providers may fax the required documentation to (701) 433-5956
ATTN: NDM Provider Enrollment

Mail:

Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment
PO Box 6055
Fargo, ND 58108-6055
Phone: (701) 277-6999

Noridian Healthcare Solutions
Attn: ND Medicaid Provider Enrollment
PO Box 6055
Fargo, ND 58108-6055

Email: NDMedicaidEnrollment@noridian.com

Phone: (701) 277-6999
Live support 9 a.m. - 3 p.m. CT, Monday - Friday. After hours voicemail available.

Fax: (701) 433-5956

Developmental Disability Providers

Phone: (701) 328-8935
Toll-Free: (800) 755-8529

Qualified Service Providers

Phone: (701) 328-4602
Toll-Free: (800) 755-2604 - to enroll

Enrolling as a Qualified Service Provider