ND Department of Human Services Medical Services Division County Jail Medical Claims Billing October 8, 2012
County Jail Medical Claims Billing
Feb 22, 2016
County Jail Medical Claims Billing. ND Department of Human Services Medical Services Division. October 8, 2012. Member Enrollment Form. Member Dis-Enrollment Form. $30 Per Claim Processed. $ Amount Paid For the Service (using ND Medicaid fee schedule). +. - PowerPoint PPT Presentation
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ND Department of Human Services
Medical Services Division
County Jail Medical Claims Billing
October 8, 2012
Member Enrollment FormND Department of Human Services, Medical Services Division 2
Member Dis-Enrollment FormND Department of Human Services, Medical Services Division 3
County Jail Medical Claims Billing Invoice
$30Per ClaimProcessed
$ Amount Paid
For the Service
(using ND Medicaid fee schedule)
+
ND Department of Human Services, Medical Services Division 4
ND Department of Human Services, Medical Services Division 5
SAMPLE
ND Department of Human Services, Medical Services Division 6
SAMPLE
ND Department of Human Services, Medical Services Division 7
SAMPLE
Processing Fee
Direct Questions to: Maggie Anderson, 701-328-1603 or
via email at [email protected]
Forms Inquiries:Mary Lou Thompson, 701-328-2322 or
via email at [email protected]
Claims Inquiries: Provider Relations, 701-328-4043
ND Department of Human Services, Medical Services Division 8
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