Certified Medical billing services in North Dakota
SwiftCare Billing provides medical billing services in North Dakota for practices that are tired of juggling payer rules. We bill ND Medicaid, Blue Cross Blue Shield of North Dakota, and Medicare through Noridian. Pricing starts at 3% of collections. Month-to-month, 30 days’ notice.
- 98.4% Clean Claim Rate
- 175+ Providers
- 50+ Specialties
- 12+ Years
North Dakota medical billing at a glance
| Item | North Dakota |
|---|---|
| Medicaid program | ND Medicaid, run by North Dakota Health and Human Services (HHS), Medical Services Division |
| How it’s delivered | Fee-for-service, plus Medicaid Expansion through one managed care plan |
| Expansion plan | Blue Cross Blue Shield of North Dakota (BCBSND), since January 1, 2022 |
| Provider enrollment | ND Health Enterprise MMIS portal |
| Medicare A/B contractor | Noridian Healthcare Solutions, Jurisdiction F (also AK, AZ, ID, MT, OR, SD, UT, WA, WY) |
| Medicare DME contractor | DME MAC Jurisdiction D |
| Medicare timely filing | 12 months from date of service |
| Medicaid fee-for-service filing | 180 days from date of service; override requests allowed |
| Expansion claims | Follow BCBSND’s own filing rules |
| Commercial payment timing | BCBSND states 30 days electronic, 45 days paper for commercial clean claims |
| Auto accident claims | No-fault; basic PIP of $30,000 is mandatory |
| Workers’ compensation | Workforce Safety and Insurance (WSI), the state fund |
Why billing in North Dakota takes state-specific work
Two Medicaid doors, two sets of rules
Most states have a dozen Medicaid plans. North Dakota has one, and only for adults in Expansion. Everyone else sits in fee-for-service, billed through the state. Sending a claim to the wrong door means a denial and lost days. Even age matters: 19- and 20-year-olds were moved out of Expansion into fee-for-service. We sort every patient by program first.
The 180-day clock is shorter than it feels.
A Medicaid fee-for-service claim must reach the state within 180 days of the service date. Billing delays, missing eligibility, or a crossover claim can eat that window quickly. There’s an override request for late claims, but it’s no guarantee. We watch the oldest open claims first.
Work requirements arrive in January 2027
New Expansion applicants will face a work requirement starting January 1, 2027, and Expansion adults will renew every six months, according to a summary of HHS rules. More renewals mean more coverage gaps mid-treatment. We verify eligibility at each visit.
Auto accident claims hit a $30,000 ceiling.
North Dakota is a no-fault state. Basic PIP pays up to $30,000 per person, and it pays first. After that, the health plan steps in. Billing the wrong payer first is an easy mistake that delays everything. We sort the order at intake.
- Our Services
Our medical billing services in North Dakota
Our healthcare billing services in North Dakota cover the full cycle, or any one piece. That covers medical coding services in North Dakota too, from AAPC-certified coders who work inside your chart notes.
We check fee-for-service versus Expansion before the visit
Codes checked against Noridian edits and BCBSND rules
Claim submission
Claims scrubbed first; tracked until paid
Denials sorted by payer and reason; root cause fixed
Oldest claims first, with the 180-day limit in mind
Payments posted; plain-language statements
Requests tracked by payer
Outsourced medical billing and coding services in North Dakota for healthcare clinics
A clinic with two providers and one front desk can’t also run a billing department. You send the encounters, and we take it from there: coding, claims, denials, follow-up. You get one named account manager and a monthly report. Nothing changes in your EHR.
Medical billing solutions for North Dakota practices of every size
Some practices want the full package. Others just need denials worked or old A/R cleaned up. We can take either, and you can add services later.
Medical credentialing and payer enrollment in North Dakota
An unenrolled provider gets no payment, plain and simple. For ND Medicaid, you apply through the Health Enterprise MMIS portal. Expansion adds a second step with BCBSND. Our medical credentialing services manage both, plus Medicare and commercial.
- NPI check and an attested CAQH profile
- Medicare enrollment through PECOS, processed by Noridian
- ND Medicaid enrollment through MMIS
- BCBSND credentialing, including the Expansion network
- Other commercial plan applications
- Revalidation reminders
Payers we bill in North Dakota
We bill ND Medicaid, Medicare and Medicare Advantage, BCBSND, and other commercial carriers. We also bill auto no-fault carriers and WSI.
Where each claim goes:
| Patient’s coverage | Who gets the claim | Clock to watch |
|---|---|---|
| ND Medicaid, fee-for-service | North Dakota HHS | 180 days from service |
| Medicaid Expansion | BCBSND | BCBSND’s filing rules |
| Medicare | Noridian | 12 months |
| Commercial, BCBSND | BCBSND | 30 days (electronic) or 45 (paper) to pay |
| Auto accident | Auto insurer | Basic PIP, up to $30,000, first |
Looking for the best medical billing services for healthcare providers in North Dakota? Start by asking each vendor how they handle the rules above. Here’s how to compare medical billing companies in North Dakota.
Medical specialties we bill for in North Dakota
We bill 50+ specialties. North Dakota practices often come to us in family practice, pediatrics, mental health, physical therapy, chiropractic, and cardiology.
EHR and practice management systems we work with
We support 80+ systems and log in to yours: Epic, athenahealth, eClinicalWorks, Tebra (Kareo), and AdvancedMD are a few. No migration needed. We link to your clearinghouse and the ND MMIS portal.
Where we work in North Dakota
Fargo, Bismarck, Grand Forks, Minot, West Fargo, Williston, Dickinson, Mandan, Jamestown, and Wahpeton, plus rural clinics anywhere in between. SwiftCare Billing serves providers in all 50 states.
Benefits of choosing SwiftCare Billing
Here’s what you get when we handle your billing:
- Fewer rejected claims. Our clean claim rate is 98.4%.
- Real coders. AAPC-certified coders and 200+ certified billers, all U.S.-based.
- One person to call. You get a named account manager, not a ticket number.
- No surprises on cost. Pricing starts at 3% of collections, with no long-term contract.
- Plain monthly reports. Collections, denials, and A/R, in numbers you can read.
- Your EHR stays. We work inside the system you already use.
- A quick start. Go-live takes 7 to 14 business days.
- A free first look. Your audit report arrives in 5 business days.
HIPAA-compliant medical billing services in North Dakota
Patient data passes through our hands every day, so privacy isn’t a footnote. Before we touch a record, you and we sign a business associate agreement. HIPAA requires it (45 CFR 164.504(e)). If something goes wrong, we owe you notice without unreasonable delay, and never later than 60 days after discovery (45 CFR 164.410). Your agreement can set a tighter deadline.
Day to day, staff see only what a billing task needs. And if you ever leave, your claims and patient accounts go with you.
Results North Dakota practices can Check
98.4% clean claim rate across SwiftCare Billing clients
Onboarding in 7 to 14 business days
Free audit report in 5 business days
Affordable medical billing for small practices in North Dakota
Smaller clinics often wonder if outsourcing is worth it. Our pricing starts at 3% of collections, and most practices pay 3% to 8%, depending on specialty, volume, and payer mix. That makes us one of the more affordable medical billing options for small medical practices in North Dakota. The contract is month-to-month.
How onboarding works
1. We audit your recent claims and send a written report within 5 business days.
2. You give us access to your EHR and clearinghouse.
3. We confirm your enrollment with Noridian, ND Medicaid, and BCBSND.
4. We review your fee schedules and payer contracts.
5. You go live in 7 to 14 business days, with monthly reports after that.
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Frequently asked questions about medical billing in North Dakota.
How much does medical billing cost in North Dakota?
Pricing starts at 3% of collections. Most practices pay between 3% and 8%. A free audit gives you a quote from your own claims.
Who handles Medicaid Expansion claims in North Dakota?
Blue Cross Blue Shield of North Dakota. It’s been the managed care plan for Expansion since January 1, 2022. Everyone else on Medicaid is billed through the state’s fee-for-service system.
Who processes Medicare claims in North Dakota?
Noridian Healthcare Solutions, in Jurisdiction F. DME claims go to DME MAC, Jurisdiction D. Medicare claims must be filed within 12 months.
How long do I have to file a Medicaid claim in North Dakota?
For fee-for-service, 180 days from the date of service. If you miss it, you can ask for an override. Expansion claims follow BCBSND’s rules instead.
How does no-fault auto billing work in North Dakota?
The auto insurer’s basic PIP pays medical bills first, up to $30,000 per person. We sort out the payer order at intake.
Do you sign a business associate agreement?
Yes, before we access any records. HIPAA requires it, and it sets breach-notice terms.
Can you work inside our EHR?
Yes. We support 80+ systems, so you keep yours.