CommercialAdministrativeMedium impact
September 2024 Quarterly Provider Insights
Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
BCBS North Dakota announced multiple upcoming changes including a new medical pharmacy prior authorization process partnering with Prime Therapeutics, new access and availability wait time standards effective January 1, 2025, and reminders about provider discounted cash rate compliance requirements.
Action Required
By January 1, 2025: Prepare for new medical pharmacy prior authorization process changes - watch for BCBSND training sessions and resources. Ensure compliance with new appointment wait time standards: Behavioral Health (10 business days), Primary Care routine (15 business days), Specialty Care non-urgent (30 business days). Review provider agreements section 3.11 to ensure discounted cash rate policies comply with contract requirements - all discounts must be available to all patients and customary charges billed to BCBSND must reflect discounted amounts.