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June 2025 Quarterly Provider Insights
Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Jun 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSND has implemented several important changes including mandatory CAQH credentialing effective June 1, 2025, enhanced time documentation requirements with preferred start/stop times for time-based services, and participation in government-mandated medical records audits with no chart fees allowed.
Action Required
Immediately: 1) All practitioners must complete credentialing through CAQH Provider Data Portal (no more paper applications). Contact prov.net@bcbsnd.com for registration assistance. 2) Providers must document start/stop times for all time-based services to support CPT, HCPCS, and ICD-10 code claims. Update EMR templates to include time fields. 3) Billing team must validate provider directory information every 90 days through Availity Essentials Portal to avoid directory suppression. 4) For RADV audit requests: provide medical records to Cognisight (877-271-1657) or Virtix Health (800-390-3180) at no charge - do not send invoices.