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Nov 21, 2024
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Become a Provider
Enroll to become a Provider by completing the appropriate online entry forms. An individual provider submitting claims to the State of North Dakota will be reported as income under your SSN to the IRS. A group provider submitting claims to the State of North Dakota will be reported as income under the groups' Employer Identification Number (EIN) to the IRS. If you need assistance, please contact Provider Enrollment at (701) 277-6999 during business office hours from Monday to Friday 8 am - 5:00 pm CST.
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Group Provider Enrollment
Individual Provider Enrollment
Download a PDF Provider Enrollment Package
Request a Provider Enrollment Package in the Mail
Become a Trading Partner
Each billing provider, clearinghouse, or billing service who will directly exchange electronic data with North Dakota Medicaid must enroll as a Trading Partner.To complete the online Trading Partner Agreement, click the link below. For additional information regarding the application process, please contact the EDI Help Desk at (844) 848-0844 during business office hours.
FAQ
Instructions
Trading Partner Enrollment
Application Status
To check the status of your North Dakota Provider or Trading Partner Application, use your Application Tracking # and click the SUBMIT button.
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Application Tracking #
Recall Provider Application
To recall an application that you have partially completed, enter your Application Tracking Number, and SSN / EIN and click the SUBMIT button.
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Application Tracking #
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SSN/EIN
Recall Trading Partner Application
To recall an application that you have partially completed, enter your Application Tracking Number and SSN / EIN and click the SUBMIT button.
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Application Tracking #
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SSN/EIN
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