Medical Billing Services in North Dakota
As a remote-first medical billing company serving North Dakota practices statewide, MedPrecision pairs ND-specific payer expertise with AAPC-certified billing experts. The deadline that catches most practices here is ND Medicaid's: its published timely-filing policy, updated October 2025 and built on North Dakota Administrative Code 75-02-05-04.7, requires an original Medicaid-primary claim within 180 days of the date of service -- not a year. Secondary and tertiary claims get 365 days, Medicare crossovers 180 days from the Medicare EOB date, and replacement or void claims 365 days where the original was filed on time. North Dakota's prompt-pay rule, N.D.C.C. 26.1-36-37.1, runs on business days: after a proof-of-loss form arrives an insurer has fifteen business days to pay, deny, or make an initial request for more information. ND Medicaid has no managed care organizations, so claims go to the state and its fiscal agent rather than to competing plans. Every North Dakota account we manage is wired to those clocks: payer-level scrubber rules, follow-up cadences keyed to the 180-day window, and appeal drafts queued the moment a denial lands.
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The North Dakota Billing Landscape
North Dakota expanded Medicaid under the ACA and runs the program as fee-for-service through the Department of Health and Human Services, with no managed care organizations in between: claims go to the state and its fiscal agent rather than to competing plans. The filing rules are correspondingly specific. ND Medicaid's published timely-filing policy, updated October 2025 and built on North Dakota Administrative Code 75-02-05-04.7, sets 180 days from the date of service for an original Medicaid-primary claim, 365 days for an original secondary or tertiary claim, 180 days from the Medicare EOB date for a crossover, and 365 days for a replacement, resubmission or void claim where the original was filed on time; a provider review of a denial must be filed within 30 days. Blue Cross Blue Shield of North Dakota is the state's Blue plan, alongside Sanford Health Plan, Medica and UnitedHealthcare on the commercial side. Sanford Health and Trinity Health are among the larger health systems. North Dakota's prompt-pay rule sits in N.D.C.C. 26.1-36-37.1 and is counted in business days rather than calendar days: fifteen business days from a proof-of-loss form to pay, deny or request information, then fifteen more once the requested information arrives. A small population spread across a large area makes access hard outside the cities, critical access hospitals serve many small communities, and telehealth carries a large share of specialist contact -- so billing teams need critical access and frontier experience, and have to work comfortably across a short payer list rather than a crowded managed care market.
Who We Serve in North Dakota
Our North Dakota client mix skews toward solo practices, rural health clinics, critical access hospitals , plus family practice groups and telehealth providers. We work with providers in Fargo, Bismarck, Grand Forks and across the rest of the state, all remotely.
Major Metros Served
What billing costs in North Dakota
We publish one national rate card and bill North Dakota practices on exactly the same terms as everywhere else — there is no regional markup and no quote-only tier below enterprise. You pay a percentage of what we actually collect, so if we do not collect, you do not pay.
| Practice size | Rate | Basis | Note |
|---|---|---|---|
| Solo practice | 7.0% | of monthly collections | Monthly minimum applies |
| Group practice | 6.0% | of monthly collections | Volume discounts available |
| Enterprise | Custom | tiered pricing | Scoped per engagement |
- No setup or implementation fee
- No per-claim charge
- No software fee and no markup on third-party costs — clearinghouse fees, postage and payer application fees are passed through at cost
- 12-month initial term, then month-to-month — 60 days' notice either way, no early-termination penalty
Payer Landscape in North Dakota
North Dakota Medicaid (fee-for-service with Medicaid expansion) is the public payer our billing team codes against day-to-day. On the commercial side, Blue Cross Blue Shield of North Dakota, Sanford Health Plan, Medica drive the bulk of North Dakota claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in North Dakota run 180 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. North Dakota's prompt-pay statute: North Dakota Century Code 26.1-36-37.1 requires an insurer, within fifteen business days of receiving a health insurance proof-of-loss form, to pay the claim or the uncontested portion of it, deny it, or make an initial request for additional information -- and to pay or deny within fifteen business days of receiving the information it first requested. The section does not set an interest penalty.
Medicaid Program
North Dakota Medicaid (fee-for-service with Medicaid expansion)
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
North Dakota Century Code 26.1-36-37.1 requires an insurer, within fifteen business days of receiving a health insurance proof-of-loss form, to pay the claim or the uncontested portion of it, deny it, or make an initial request for additional information -- and to pay or deny within fifteen business days of receiving the information it first requested. The section does not set an interest penalty.
North Dakota Billing Regulations & Compliance
The North Dakota Insurance Department sets the rules our North Dakota billing workflows have to satisfy. Surprise billing in North Dakota: Federal No Surprises Act applies; no additional state-specific surprise billing law. Telehealth parity: North Dakota Century Code 26.1-36-09.15 requires an insurer's policy to cover telehealth-delivered services the same as in-person services. Payment may still be set through network negotiation, and the statutory definition of telehealth excludes email, fax and audio-only telephone except for e-visits and virtual check-ins.
State Insurance Regulator
North Dakota Insurance Department
Surprise Billing Protection
Federal No Surprises Act applies; no additional state-specific surprise billing law.
Telehealth Billing Parity
North Dakota Century Code 26.1-36-09.15 requires an insurer's policy to cover telehealth-delivered services the same as in-person services. Payment may still be set through network negotiation, and the statutory definition of telehealth excludes email, fax and audio-only telephone except for e-visits and virtual check-ins.
Common Questions
Common questions about medical billing services in North Dakota.
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Get a Free Billing AuditHow does MedPrecision handle North Dakota Medicaid fee-for-service billing?
ND Medicaid is a fee-for-service program with no managed care organizations, so claims route to the state and its fiscal agent. We work from ND Medicaid's published billing and policy manual, and the filing rule we build the queue around is the one in its timely-filing policy (updated October 2025): an original Medicaid-primary claim must be received within 180 days of the date of service. Proof of timely filing is the provider's responsibility, and ND Medicaid names what it will accept -- its own transaction control number and remittance date, a Medicare or third-party EOB, a retroactive-eligibility letter, or a date-stamped claim it returned. It will not accept a report generated by your own office or billing software, which is why we keep the payer's own acknowledgements, not ours.
Can MedPrecision support frontier and rural practice billing in North Dakota?
Yes. Critical Access Hospitals and Rural Health Clinics bill under cost-based and encounter-based rules that do not behave like a standard professional claim, and telehealth adds distant-site and originating-site requirements on top. We set up the charge capture, modifier logic and place-of-service handling for those settings, and we verify the current rule with the payer rather than carrying a rule over from another state.
What are North Dakota's timely filing requirements, and how does MedPrecision track them?
ND Medicaid's published deadlines, from its timely-filing policy updated October 2025, are: 180 days from the date of service for an original Medicaid-primary claim; 365 days for an original secondary or tertiary claim submitted with third-party payment information; 180 days from the Medicare EOB date for a Medicare crossover (and providers are told to wait 60 days from that EOB date before submitting, because crossover transactions can take 60 to 90 days); and 365 days from the date of service for a replacement, resubmission or void claim where the original met the 180-day rule. A provider review of a payment denial must be filed in writing with the department within 30 days of the denial. Commercial payers set their own limits by contract. We track every claim against the limit that applies to it and prioritize the ones nearing a deadline.
How does MedPrecision support telehealth billing for rural North Dakota practices?
N.D.C.C. 26.1-36-09.15 requires an insurer's policy to cover health services delivered by telehealth the same as the same services delivered in person -- but the same section lets payment be settled through ordinary network negotiation rather than mandating in-person rates, and its definition of telehealth excludes email, fax and audio-only telephone except for e-visits and virtual check-ins. That distinction is where telehealth claims in North Dakota get denied. We bill telehealth with the place-of-service code and modifiers the specific payer publishes, and we check the audio-only question before the encounter rather than after the denial.
What happens if a North Dakota payer misses the prompt-pay deadline?
North Dakota's rule is N.D.C.C. 26.1-36-37.1, and it is measured in business days. After receiving a health insurance proof-of-loss form the insurer has fifteen business days to pay the claim or the uncontested part of it, deny it, or make an initial request for additional information; a contested claim must be identified in writing with the reasons. Once the information it first asked for arrives, the insurer has another fifteen business days to pay or deny. The statute does not set an interest penalty, so the remedy is regulatory rather than automatic: we document the dates, escalate the stalled claim, and raise it with the North Dakota Insurance Department when a payer will not move.
How do I choose a medical billing company in North Dakota?
Prioritize a billing company that already works with North Dakota Medicaid and the major commercial payers in North Dakota — payer-specific edits and timely-filing windows are where most ND revenue leaks start. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Because billing is delivered remotely, a company's North Dakota payer experience matters more than a local office address.
Services for North Dakota practices
Specialties we bill for
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Tell us the specialty and we will come back on what your North Dakota payer mix actually changes — filing windows, the state's prompt-pay clock, and which plans your claims are going to. Written findings in 3–5 business days.
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Services in North Dakota
Specialties in North Dakota
Other Locations We Serve
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