Online Application Quick Reference Guide - nd.gov
1 Created 8/24/2017 Revised 9/6/2019 JS North Dakota Department of Human Services Medicaid Provider Enrollment Online Application Guide Table of Contents General Notes ........................................ ........................................ ........................................ ....................... 3 Individual Application ........................................ ........................................ ........................................ ........... 4 Screen 1 - Identifying Information.
Online Application Quick Reference Guide . ... • EFT – DO NOT mark yes if this is a individual provider. Only individuals who have no billing ... guide for more information on registering after the application is approved. Click “Save” Click “Validate” Screen 11
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