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The FAQs will be updated as ND Medicaid receives more questions on the ND Health Enterprise MMIS

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Browse Questions

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On ND Health Enterprise, do I still bill with a Medicaid ID?

No, you will bill using your NPI and taxonomy. Only those providers who do not enroll with an NPI will bill using their new 7-digit Medicaid provider number. Those providers are travel/lodging providers, Developmental Disability (DD) waivered service providers and Qualified Service Providers (QSP).

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Will I need to list the NPI and taxonomy on a claim for a rendering provider?

Yes, the same requirements apply for a rendering, attending or servicing provider to submit using their NPI and taxonomy.

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How is Taxonomy defined?

It is defined by provider type and provider specialty. It is not uniquely assigned to an individual.

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How do I learn what NPI and taxonomy I enrolled with?
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Should I place taxonomy on ND Medicaid paper claims today?

No, continue to use your current Medicaid provider number until we launch ND Health Enterprise.

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Will Developmental Disability (DD) waivered service providers bill with taxonomy and/or NPI?

No, DD providers will not submit taxonomy when billing for waivered services. Taxonomy will be required when billing for ICF/IID services.

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Where do I list the taxonomy for a rendering physician on a CMS1500 claim form?

The taxonomy for a rendering provider should be listed in Box 24J.

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When submitting an electronic claim, do we submit taxonomy for the provider or the facility?

You will need to submit taxonomy for both the provider and the facility as supported by the claim form.

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After the transition from the Legacy system to ND Health Enterprise, will you use a Medicaid provider number?

No, but we will issue you a new 7-digit Medicaid provider number to further identify you as a provider and as another form of validation.

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If a hospice provider submits claims for nursing facility room and board, does the provider submit both the nursing facility and hospice taxonomy?

You will use the taxonomy of the billing provider, which is the hospice agency.

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When do I use an affiliation form?

An affiliation form is used when rendering provider needs to be affiliated with a billing provider. A rendering provider does not need to reenroll if they are already enrolled with ND Medicaid. However, Provider Enrollment needs to validate each affiliation.

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Who do third party billers contact for taxonomy?

Third party billers are not assigned taxonomy. They are not an enrolled provider with ND Medicaid. Only email inquiries will be accepted from the third-party biller. Email inquiries will be answered in the order they are received. The third-party biller will receive an email response within 7-10 business days.

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If we have a current trading partner with ND Legacy MMIS do we need to request a new one with ND Health Enterprise?

Yes, you will have to register as a trading partner for ND Health Enterprise. You will also have to complete SFN 109 or SFN 111 in order to receive an 835 electronic remittance advice.

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When we filled out our enrollment form, we were using different electronic transaction submission software from what we are currently using. Do we need to change what is on record with ND Health Enterprise?

Yes, you should keep your information current. Please call the EDI hotline at 1 (844) 484-0844 to update your information.

The email address for inquiries is ndmedicaid-thirdpartyinquiries@direct.ndhin.com. Please note that to utilize the email address, third-party billers will need to enroll to join the North Dakota Health Information Network (NDHIN). The NDHIN is a secure, online network.

Entities can sign up by visiting: www.ndhin.org/services.

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Contact Information

Medical Services Division
North Dakota Health and Human Services
600 E. Boulevard Ave., Dept. 325
Bismarck, N.D. 58505-0250
Phone: (800) 755-2604
Fax: (701) 328-1544
711 (TTY)
Email: dhsmed@nd.gov