Hospital identification tag being put onto a newborn baby's footA doctor taking a patient's blood pressureA caring adult's hand holding a baby's tiny handMedical worker wearing stethoscopeDental hygienist performing an oral hygiene procedure on a pediatric patient

Welcome   Skip portlet

Welcome to the North Dakota MMIS Web Portal.

Provider Registration   Skip portlet
To obtain a user id and password, Providers and Trading Partners must have an approved enrollment with North Dakota and have received their Provider or Trading Partner ID.

System Message   Skip portlet

System updates have been made to the North Dakota Health Enterprise Medicaid Management Information System (ND HE MMIS) that make Primary Care Provider (PCP) information available to providers through use of the 270/271 (Health Care Eligibility Benefit Inquiry and Response) electronic data interchange transactions.  Please note the ND HE MMIS Web Portal and Automated Voice Response System (AVRS) may also be used to access PCP information.

 Due to the system issues associated with PCP assignment and retrieval experienced since the implementation of ND HE MMIS, edits impacting claims processing in relation to the Primary Care Case Management (PCCM) program and associated with PCP referrals will receive an exemption through June 30, 2016.  System updates have been made in ND HE MMIS which have corrected these various issues along with making PCP information available via the 270/271 transaction.

Providers will need to resubmit all claims that may have been denied in relation to these PCP-related issues.  These are claims that would have denied with either a Claim Adjustment Reason Code ‘38’, or a Claim Adjustment Reason Code ‘243’, on your remittance advice.  Please note that timely claims submission requirements (providers must submit all claims no later than 12 months from the date of service) still apply to all claims.  However, if you have submitted a claim and it has been denied, you have one year from the last remittance advice date of the denied claim to resubmit or adjust the claim.

As mentioned above, claims that have been denied in ND HE MMIS since implementation due to PCP-related referral purposes may be resubmitted for processing in order to obtain the edit exemption.

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