North Dakota Medicaid — North Dakota Medicaid (Traditional + Medicaid Expansion)
| Program name | North Dakota Medicaid (Traditional + Medicaid Expansion) |
|---|---|
| Provider portal | https://www.hhs.nd.gov/medicaid |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 365 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the North Dakota Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in North Dakota
The Blue Cross Blue Shield Association licensee in North Dakota is Blue Cross Blue Shield of North Dakota (Noridian). This licensee is not yet in the QuickIntell payer registry. See the full payer directory or the BCBSA national site for a provider-portal link.
Top commercial payers in North Dakota
The dominant commercial insurers operating in North Dakota, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in North Dakota
North Dakota Medicaid MCO data has not yet been populated in the registry.
State-specific regulations affecting North Dakota billing
- N.D. Cent. Code §26.1-36.3 (Balance Billing — HB 1427, 2019)
- N.D. Cent. Code §26.1-36.1 (prompt pay — 30 days electronic clean claim)
- N.D. Cent. Code §50-24.1-28 (hospital financial assistance / charity care)
Provider licensing & enrollment in North Dakota
Providers enroll via ND Medicaid Provider Enrollment (ND MMIS). Sanford Health Plan administers Medicaid Expansion claims.
Major health systems headquartered in North Dakota
| Health system | Headquarters |
|---|---|
| Sanford Health (Fargo) | Fargo, ND |
| Essentia Health (North Dakota) | Fargo, ND |
| Altru Health System | Grand Forks, ND |
| CHI St. Alexius Health (CommonSpirit) | Bismarck, ND |
| Trinity Health ND | Minot, ND |
Frequently asked questions — North Dakota billing
What is the North Dakota Medicaid program called?
North Dakota's Medicaid program is known as North Dakota Medicaid (Traditional + Medicaid Expansion). Providers enroll and manage claims through the provider portal at https://www.hhs.nd.gov/medicaid.
What is the North Dakota Medicaid timely filing limit?
North Dakota Medicaid (Traditional + Medicaid Expansion) requires initial claims to be filed within 365 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; North Dakota's 365-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does North Dakota Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for North Dakota Medicaid (Traditional + Medicaid Expansion). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in North Dakota?
The dominant commercial payers in North Dakota include UnitedHealthcare, Aetna, Cigna, Humana, Medica, along with the BCBS licensee Blue Cross Blue Shield of North Dakota (Noridian). Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in North Dakota?
North Dakota Medicaid MCO data has not yet been populated in the registry. Consult the state Medicaid portal for the current MCO roster.
What state-specific billing regulations apply in North Dakota?
North Dakota has 3 tracked state-level statutes that affect medical billing and RCM: N.D. Cent. Code §26.1-36.3 (Balance Billing — HB 1427, 2019); N.D. Cent. Code §26.1-36.1 (prompt pay — 30 days electronic clean claim); N.D. Cent. Code §50-24.1-28 (hospital financial assistance / charity care). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in North Dakota with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to North Dakota Medicaid (Traditional + Medicaid Expansion) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from North Dakota Medicaid and the member ID card before submission.