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North Dakota

North Dakota Behavioral Health Credentialing And Payer Enrollment

If you’re a behavioral health provider getting credentialed in North Dakota, traditional Medicaid is one state enrollment with no plan to chase, and Medicaid Expansion adds one step with BCBSND. Commercial runs on CAQH, Sanford and HealthPartners excepted, and no statute puts a clock on a carrier or pays you for the wait. The trap is Cigna, whose behavioral network here is HealthPartners, so a file sent to Evernorth went to the wrong place. Here’s the order, the out-of-state rule, and what only you can sign.

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North Dakota Payers And Timelines

What’s Different Here

Four North Dakota Rules That Decide Where Your Applications Go.

None of these show up on a generic credentialing checklist. Each one of them can cost a practice a full quarter if you find it the wrong way round.

The Cigna Door Here Is HealthPartners

A strategic alliance running since 2006
  • The January 2026 alliance quick reference states that members with Cigna coverage access care through the HealthPartners network in Minnesota, North Dakota and western Wisconsin, and that providers there are paid at HealthPartners contracted rates
  • Evernorth’s September 2026 behavioral administrative guidelines say the same from the plan side: providers in those states must be contracted through HealthPartners to be in network for Cigna Healthcare coverage
  • Cigna’s own behavioral network page closes the loop, telling practitioners in those markets to complete the HealthPartners Behavioral Health Contract Inquiry
  • Outside the alliance area, Cigna-covered members reach you through the Cigna network as normal. One national contract still covers every state you’re licensed in

Separate door: HealthPartners, not Evernorth

Out-Of-State Enrollment Is A Real Gate

And it decides how a telehealth practice gets built
  • ND Medicaid states it doesn’t enroll out-of-state providers if the service is available in state. Very few states say that out loud
  • The carve-out that matters: services delivered while the member is physically located in North Dakota, by a provider meeting the licensing requirements for that practitioner type, aren’t treated as out-of-state care
  • The state publishes an Out-of-State Telehealth Attestation for exactly that situation
  • Settle this before you build a multi-state plan around North Dakota, not after an application comes back

Two Medicaid Doors, And The Second One Is A Blue Plan

Traditional fee-for-service, plus Expansion
  • Traditional North Dakota Medicaid is fee-for-service. You enroll with the state, you bill the state, and no plan sits in between
  • Medicaid Expansion is managed care, administered by Blue Cross Blue Shield of North Dakota since January 1, 2022, taken over from Sanford Health Plan
  • BCBSND says it plainly: you must be credentialed with the State of North Dakota and with BCBSND
  • Already contracted with BCBSND commercial? That second step is usually a Medicaid Expansion addendum through provider contracting, not a fresh application

No Clock, And No Retroactive Right

NDCC chapter 26.1-47
  • North Dakota’s preferred provider law sets real obligations: 60 days notice before a without-cause termination, and arrangements filed with the Insurance Commissioner within ten days
  • It sets no credentialing decision deadline and creates no retroactive payment right. We read it looking for both
  • BCBSND policy makes credentialing effective on the committee or chair approval date, and it tells you not to submit claims before the approval notification arrives because the system will deny them
  • Its 2026 policy can date your setup back to when you joined a participating group, but generally no more than 90 days before it received the application, so filing early is the only lever you control

Where The Delays Happen

Getting On A Panel Isn’t The Same As Getting Paid.

The waiting happens between these five steps more than inside them. We work each gap and tell you where your file is sitting.

Credentialed›contracted›loaded›connected›payable

Medicaid And Commercial Work Differently Here.

Two Tracks

Both doors in North Dakota are short. The mistakes are in the order things happen, not in the volume of paperwork.

North Dakota Medicaid

One State Enrollment, One Plan Step, One Specialist Lane.

There’s no behavioral health carve-out vendor between you and payment for a fee-for-service member. Policy and the public system sit with the ND HHS Behavioral Health Division and the regional Human Service Centers, which coordinate services and license some program types. Your patients may already be connected to one, but it isn’t a payer you contract with for routine outpatient work.

How you enrollOnline in the ND Health Enterprise MMIS Web Portal. The state contracts with Noridian Healthcare Solutions to complete provider enrollment for everyone except Qualified Service Providers. Electronic submission assigns an Application Tracking Number, which is how you check status, so we save it the moment it’s issued.
There’s no generic checklistNorth Dakota publishes a separate application-requirements sheet per provider type, and the behavioral health categories are split out on their own, including Community Behavioral Health, Behavioral Health Rehabilitation, 1915(i) individual and group, and Methadone and Suboxone. Several roles carry their own attestation form on top.
Forms you’ll see

Individual or Group Enrollment ApplicationAdditional Service Location formMedicaid Provider Participation AgreementProvider Enrollment CoversheetOut-of-State Telehealth Attestation

1915(i) goes first, not lastThe home and community based behavioral health lane runs on its own track. The group enrolls first, and an individual won’t be approved without an affiliation to an approved group. It carries criminal background screening and its own attestations, and Expansion members need a separate BCBSND 1915(i) contract request.
Prescribers, read thisFederal law requires anyone who prescribes, orders, refers or bills for a North Dakota Medicaid member to be enrolled. So a prescriber whose own billing is entirely commercial still has a reason to be in the file.
One live constraint worth readingEffective June 11, 2026 the state put a temporary enrollment moratorium on non-emergency medical transportation agencies statewide, and on Qualified Service Provider and Developmental Disability agencies in Burleigh and Cass counties. It doesn’t touch behavioral health prescribers or anyone already enrolled, but applications in those categories that had not reached final approval were denied, so it matters if a related entity is in your plans.

Commercial

BCBSND Is The Market. Then It Gets Interesting.

Blue Cross Blue Shield of North Dakota credentials behavioral health itself rather than handing it to a carve-out vendor, and Nurse Practitioner, Physician Assistant, Psychiatric Nurse Specialist and Psychologist all appear by name on its Professional Health Care Provider list. A psychiatric prescriber is a recognized category here, not an exception request.

Contracting first, credentialing secondThat order is the opposite of what people assume, and BCBSND won’t execute the participation agreement to add your organization to its networks until credentialing is complete. A contract request starts by sending provider contracting your W-9, organization NPI, the list of practitioners and NPIs, the services you provide, the directory business name and a member-accessible phone number.
Your CAQH stays yoursYou complete and attest your own profile. We’re added as an authorized practice manager, so we keep the practice data current during your project and get each payer authorized. After that, Credentialing Maintenance keeps it current. If you want us to maintain your profile, you share access securely and change the password when we’re done. BCBSND takes practitioner applications only through the DataSpring Provider Data Portal (formerly CAQH) now, and the signature cannot be dated more than 180 calendar days before committee review.
Two carriers sit off CAQHSanford Health Plan runs its own forms through the Sanford Provider Hub. HealthPartners has contracted groups add practitioners through its own Provider Data Profiles application. So an attested CAQH profile doesn’t cover the whole state, and there’s no state-designated database to fall back on.
Behavioral health has its own doorUnitedHealthcare goes through Optum and Provider Express. Cigna goes through HealthPartners in this state. Aetna keeps it in house, on the same request for participation as medical. BCBSND, Sanford and HealthPartners each credential behavioral health inside the plan. Guessing wrong costs weeks, not days.
Seeing patients in other statesAetna, Cigna and UnitedHealthcare are national networks. One BCBSND contract reaches Blue members who live in other states through BlueCard. What you need is a license where the patient is sitting, not another contract. Medicaid is the genuine exception.

Who You’ll Apply To, And How Long It Usually Takes.

North Dakota Commercial Payers

These are typical ranges from a complete application. No North Dakota statute sits underneath them, so we track the dates rather than promise them.

Blue Cross Blue Shield Of North Dakota

The carrier the state runs on
  • Usually: BCBSND tells new providers credentialing can take up to 90 days once the specialist has a completed application. Its own 2026 policy is written wider, at 180 calendar days from the signature date or 90 days from the receipt date. Confirm at submission
  • Order: contracting first, then credentialing, and the participation agreement isn’t executed until credentialing finishes
  • Effective date: the committee or chair approval date. The 2026 policy can then date your setup back to when you joined a participating group, generally no more than 90 days before BCBSND received the application, and BCBSND tells you not to bill before the approval notice lands
  • Recredentialing: every 36 months. Miss it and the record terminates, claims stop, and getting back in means a full initial application with no adjustments for the gap
  • Also: institutional and facility lines still use paper, including a separate Behavioral Health Institutional Provider application

UnitedHealthcare And Optum

The strongest published opening in the state
  • Usually: 60 to 120 days from a complete application
  • Path: behavioral health starts inside Provider Express with Join Our Network. Optum states CAQH participation is required for credentialing in North Dakota
  • What Optum says it needs here: MDs, DOs, PAs and RNs with prescriptive authority in all counties, plus telemental health and medication assisted treatment prescribers. PhD and master’s level clinicians narrow to Grand Forks, Ward and Cass
  • Watch: the medical network is a different application. Starting there is the common way to lose several weeks

Separate door: Optum Behavioral Health

HealthPartners

Counts twice, which is why it gets its own card
  • Usually: HealthPartners doesn’t publish a turnaround. It says timing depends on whether the application is complete, whether it needs more from you and whether you meet its credentialing criteria, and it notifies you in writing once you’re approved
  • Path: once your group is contracted, it adds you through the Add Practitioner search in HealthPartners’ Provider Data Profiles application
  • Why it’s double duty: a HealthPartners contract reaches HealthPartners-covered members here and, through the alliance, Cigna-covered members here
  • Write this part carefully: its behavioral health application asks you to name the age groups, services and verifiable areas of expertise you offer. That section is what argues for you
  • One caution: HealthPartners tells behavioral health providers in Minnesota and its bordering counties to enroll with the state Medicaid agency first. That’s a Minnesota program requirement, not a North Dakota instruction

Cigna Healthcare And Evernorth

Routed through HealthPartners in this state
  • The route: in Minnesota, North Dakota and western Wisconsin, contract consideration runs through the HealthPartners Behavioral Health Contract Inquiry, not through Evernorth
  • Current application route: In Minnesota, North Dakota, and western Wisconsin, Evernorth directs providers to HealthPartners for managed care contracting. Evernorth handles Employee Assistance Program (EAP) contracting separately. Check the applicable route before applying.
  • Why it matters less here: the contract that puts you in front of Cigna-covered North Dakota patients is a HealthPartners contract, and that path is separate
  • Card check: a patient card saying Cigna, GWH-Cigna or carrying a G prefix in North Dakota routes over HealthPartners. We confirm rather than assume

Separate door: HealthPartners Behavioral Health Contract Inquiry

Sanford Health Plan

A health system and a health plan at once
  • Usually: Sanford doesn’t publish an initial turnaround, because the first gate is a contracting decision rather than a queue. A Provider Contracts Specialist reviews the Contract Request Form, and only if you meet its contracting eligibility criteria do you get an offer and an invitation to credential
  • Path: Contract Request Form, then the Provider Enrollment Application, then Individual Provider credentialing through the Sanford Provider Hub for anyone billing on the CMS-1500. This is the North Dakota carrier that sits off CAQH
  • Stale habit to drop: Sanford ran North Dakota Medicaid Expansion before BCBSND took it on January 1, 2022, so older material still points here for that book. It shouldn’t
  • Worth holding in the Fargo, Bismarck and Dickinson corridors where its system footprint is heaviest

Aetna

Size it against your actual patient mix
  • Usually: a request for participation, then a network-need answer on eligibility, then credentialing pulled from CAQH, then contracting. Commonly 60 to 120 days from start to finish
  • Path: behavioral health uses the same Aetna request for participation as medical
  • Watch: in a small commercial market, Aetna’s practical value tracks how much self-funded and national-employer coverage is in your panel. Worth sizing before you spend the effort

One honest gap, because we would rather say so than fill it in. Medica is a Minnesota-based carrier whose network reaches into the Upper Midwest and it’s a reasonable candidate for a North Dakota panel, but its site blocked every automated request we made, so we couldn’t verify its current North Dakota footprint or credentialing route from its own pages. We confirm that one live during onboarding rather than describing a carrier we couldn’t read. Humana isn’t a commercial option here either: it announced its exit from employer group commercial medical in 2023 and phased it out, so in North Dakota it’s a Medicare Advantage conversation. Medicare, and North Dakota Medicaid including the BCBSND Expansion book, are government enrollment, which is $450 per provider for each Medicare, Medicaid or Medicaid plan enrollment and can be bought on its own or with a package.

Carry A Plan We Didn’t List? Add It.

North Dakota’s odd routes are worth knowing about. Self-funded employer plans and Taft-Hartley union health and welfare trusts usually reach you through a rented network rather than a direct contract, and here that network is most often BCBSND or a national carrier, while Cigna-branded self-funded coverage lands on HealthPartners under the alliance. The Human Service Centers and the ND HHS Behavioral Health Division run the public system, including substance use services and programs like Free Through Recovery, which your patients may already be using even though it isn’t a contract you hold. And Noridian, the company processing your Medicaid enrollment for the state, is a BCBSND-affiliated entity, which surprises people but doesn’t change the paperwork. You name the plan. We find the real route.

Send These Once And We Can Start.

What We Need From You

  • Your individual NPIPlus the group NPI if you bill under a business. ND Medicaid wants the NPI to carry the right taxonomy for what you’re enrolling to provide, and a mismatch is a common reason a North Dakota application comes back.
  • Active North Dakota license and DEAND Medicaid requires a paper copy of the issued license or certification with the application, and BCBSND primary source verifies license, DEA or CDS, and board certification.
  • CAQH attested and authorizedYou attest it. We keep it current during your project. BCBSND now takes practitioner applications only through the CAQH portal, and Optum requires CAQH participation here. Sanford and HealthPartners are the two exceptions, and we prepare those separately.
  • Where your patients are when you see themThis matters more in North Dakota than almost anywhere. The state doesn’t enroll out-of-state providers when the service is available in state, with a telehealth carve-out for members physically located in North Dakota and its own attestation form.
  • Delegated portal accessSo we can complete your ND MMIS enrollment and the BCBSND Expansion step without anyone sharing a password. Plus the Application Tracking Number once the portal issues it, and confirmation of the contact and mailing details, because that’s where revalidation notices go.
  • Every service location you’ll bill fromND Medicaid needs a separate Additional Service Location form for each location past the first, and BCBSND asks for the directory business name and a member-accessible phone number with the contract request.
  • Malpractice certificateWith coverage amounts and effective and expiration dates. BCBSND requires the certificate or an accompanying letter to state clearly that you personally are covered, which a generic group face sheet often doesn’t do.
  • Legal business name, EIN, and W-9One per tax ID you bill under. ND Medicaid wants the W-9 as a hard copy with the application, and BCBSND asks for it with the signed agreement and again at the contract request.
  • Ownership and disclosure detailAnyone with a 5 percent or greater interest, plus managing employees and relevant subcontractors, and any adverse legal actions. North Dakota collects this at enrollment and again at revalidation.
  • Five years of work historyMonth and year, with any gap over six months explained in writing. BCBSND names this specifically, and it’s one of the most common reasons a clean-looking file stalls.

North Dakota licenses the program rather than the clinician, so depending on what you plan to offer the practice itself may need a license separate from your own. NDCC chapter 50-31 says nobody may establish, conduct or maintain a substance use disorder treatment program in the state without one, and the application is built around an entity, a location and named people in charge, which is the usual signal that a regime aims at organizations running programs. The Behavioral Health Division separately licenses Psychiatric Residential Treatment Facilities. It tends to come up when a practice adds substance use treatment, an opioid treatment program or a residential setting, or asks ND Medicaid to enroll it under one of the behavioral health program categories. A solo prescriber doing outpatient medication management often doesn’t run into it. We confirm during onboarding, before it can slow down an enrollment or a payer contract. We don’t give legal advice and we don’t file it for you.

We handle credentialing and payer enrollment in North Dakota and in the other 49. Physicians and outpatient medical groups, psychiatrists included, start on the physician credentialing page.

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ND MMIS enrollment, the BCBSND Expansion step and every commercial file, including the HealthPartners route for Cigna patients.

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Your NPPES record, CAQH/DataSpring profile, ND MMIS account and payer contracts stay in your name, and the paperwork is yours too. You keep all of it if we stop working together.

North Dakota Credentialing Questions

Questions We Get

How Do I Get In Network With Cigna In North Dakota?
Through HealthPartners, not Evernorth. Cigna and HealthPartners have run a strategic alliance since 2006, and in Minnesota, North Dakota and western Wisconsin the Cigna behavioral network is the HealthPartners network. The January 2026 alliance quick reference says Cigna-covered members here access care through HealthPartners and that providers in that area are paid at HealthPartners contracted rates. Evernorth’s September 2026 administrative guidelines say the same thing from the plan side. And Cigna’s own behavioral network page tells practitioners in those markets to complete the HealthPartners Behavioral Health Contract Inquiry for contract consideration. So the contract that puts you in front of Cigna patients in North Dakota is a HealthPartners contract, and filing with Evernorth for those patients is filing in the wrong place.
Which Application Route Reaches Cigna Patients In North Dakota?
In Minnesota, North Dakota, and western Wisconsin, Evernorth directs providers to HealthPartners for managed care contracting. Evernorth handles Employee Assistance Program (EAP) contracting separately. Check the applicable route before applying.
Can I Enroll With North Dakota Medicaid If I Am Based Out Of State?
Not if the service is available in state. ND Medicaid states it doesn’t enroll out-of-state providers in that case, which is unusual and it changes how a telehealth practice has to be structured here. There’s a real carve-out. Services delivered to members while they’re physically located in North Dakota, by a provider who meets the licensing requirements for that practitioner type, aren’t treated as out-of-state care, and the state publishes an Out-of-State Telehealth Attestation for exactly that. We need the honest picture of where your patients sit when you see them, because it decides which lane the application goes in and there’s no cheap way to change lanes later.
Does My North Dakota Medicaid Enrollment Cover Medicaid Expansion Patients?
No, and this is the one managed care layer in the state. Traditional North Dakota Medicaid is fee-for-service, so you enroll with the state and bill the state with nothing in between. The Medicaid Expansion population runs under a managed care contract that Blue Cross Blue Shield of North Dakota has administered since January 1, 2022, taking it over from Sanford Health Plan. BCBSND says it plainly: to be a provider in the Expansion program you must be credentialed with the State of North Dakota and with BCBSND. If you already participate with BCBSND commercial, that second step is usually a Medicaid Expansion addendum through provider contracting rather than a fresh application, which is worth knowing before somebody starts one from scratch.
How Long Does Credentialing Take In North Dakota, And Does Anyone Pay Me For The Wait?
Plan for 60 to 120 days per commercial payer from a complete application, and expect no help from the statute. We read NDCC chapter 26.1-47, which governs preferred provider arrangements and does set real obligations, including 60 days notice before a without-cause termination and a requirement that carriers file arrangements with the Insurance Commissioner within ten days. It sets no credentialing decision deadline and creates no retroactive payment window. In practice, BCBSND policy makes credentialing effective on the committee or chair approval date, and it tells providers not to submit claims before the approval notification arrives because the system will deny them. Its 2026 policy can date your setup back to when you joined a participating group, but generally no more than 90 days before BCBSND received the application. So in North Dakota you file early.
Do All North Dakota Payers Use CAQH?
Most do, and two don’t, which is the part that catches people. BCBSND moved practitioner applications to the DataSpring Provider Data Portal (formerly CAQH) and no longer accepts paper practitioner applications. Optum states CAQH participation is required for credentialing in North Dakota, and Aetna pulls from CAQH. The exceptions are Sanford Health Plan, which runs its own forms through the Sanford Provider Hub, and HealthPartners, which has contracted groups add practitioners through its own Provider Data Profiles application. There’s no state-designated credentialing database here either. A document called the North Dakota Initial Credentialing Application does circulate from carriers, but the copy we verified is dated October 2015 and carries carrier acceptance language rather than any statutory mandate.
Where Does A UnitedHealthcare Behavioral Health Application Go In North Dakota?
Through Optum, inside Provider Express, using the Join Our Network flow. It’s a separate application from core UnitedHealthcare medical, and applying at the medical door is the common way to lose several weeks. Optum publishes the strongest opening in the state for a psychiatric prescriber: its North Dakota page lists MDs, DOs, PAs and RNs with prescriptive authority as needed in all counties, and separately names telemental health and prescribers providing medication assisted treatment as actively sought. For PhD and master’s level clinicians it narrows to Grand Forks, Ward and Cass counties, which tells you where the population is. Cigna’s behavioral door here is HealthPartners, and Aetna uses the same request for participation as medical.
What Is 1915(I), And Do I Need It?
It’s North Dakota’s state plan amendment for home and community based services for adults and children with behavioral health conditions, approved by CMS in January 2021 and launched that February. It enrolls on its own track and the sequence is strict: the group enrolls first, and an individual 1915(i) provider won’t be approved without an affiliation to an already approved group. It also carries a criminal background screening requirement and its own attestations, and if you’ll serve Medicaid Expansion members you request a BCBSND contract for 1915(i) services on top of the state enrollment. If those services are in your scope, that group enrollment goes at the front of the queue. Put it at the back and everything else waits on it.

Related

Keep Reading

North Dakota PMHNP scope of practiceWhat North Dakota allows you to do, separate from who pays you.
Minnesota credentialingThe big plans run on ApplySmart and the Minnesota Uniform Credentialing Application, not CAQH.
South Dakota credentialingPure fee-for-service Medicaid, plus a 90-day clock and payment for the wait.
Montana credentialingFee-for-service with no managed care at all, and no credentialing clock either.
Opening your own practiceBusiness setup, identifiers, payers, EHR, and billing setup.
Adding a provider to your clinicFirst-time credentialing into contracts you already hold.
Changing your business or tax IDMoving panels without breaking the money.

Ready To Bill In North Dakota?

Pricing starts at $450 per payer, per provider. One payer is enough to start. Fill out the onboarding packet and we’ll map your ND MMIS enrollment, the BCBSND Expansion step and your commercial set, including the HealthPartners route.

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Official Pages For North Dakota

North Dakota Medicaid Provider EnrollmentEnroll or revalidate as a Medicaid provider.North Dakota Board of Nursing APRN LicensureNurse practitioner (APRN) licensing.North Dakota Board of Counselor ExaminersLicensing for therapists and counselors.North Dakota Board of Social Work ExaminersLicensing for therapists and counselors.

Where This Comes From

Links checked automatically on October 14, 2026. A source carries that stamp only when its page loaded and had not changed since the date we verified it.

We last reviewed this page on October 1, 2026. Each source listed shows the date we last verified it, and we will review the whole page again by January 18, 2027.

Payer programs, plans and timelines change. Everything here carries a verification date and gets re-checked on a review cycle. We will check these facts again by January 18, 2027. Approval and effective dates are controlled by each payer and by the state, and nothing here promises an approval, a timeline or a rate. This page covers payer operations. It isn’t legal, tax or scope of practice advice.

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