Healthy Steps Network Referral and Requirements
Issue: #403 SEP2018
As of January 1, 2018, it is a requirement that all providers be enrolled with the North Dakota Department of Human Services Medicaid program and be a participating provider with Blue Cross Blue Shield of North Dakota (BCBSND) to receive payment for Healthy Steps members. This also affects the authorized referral process for in-state providers that are not in the Healthy Steps network. Claims will not be paid with or without an authorized referral to in-state providers that are not enrolled in Medicaid. Only qualified Healthy Steps providers will receive claim payment from BCBSND.
Effective July 1, 2018, the ND Department of Human Services Medicaid program requires National Drug Code (NDC) codes on all medical drug claims for Healthy Steps members. Claims that do not meet this requirement will be denied. Please note this change does not include vaccines.