1. Healthcare providers will bill contractor directly for NDCS incarcerated individuals’ healthcare provided offsite or on-site of a NDCS facility. NDCS will notify contractor if services are to be billed as an exception to the contract, i.e., Medicaid, NDCS direct billing; such claim exceptions will not be processed and will be rejected by the contractor. 2. Individuals on parole or individuals in the custody of NDCS on behalf of a county jail will not be factored into the average daily population (ADP) and at this time are considered outside the scope of services. 3. Pay networked provider claims in accordance with contractor’s internal network provider agreement. 4. NDCS approved dental services. 5. Pregnancy care: This will include prenatal and postnatal care for the mother only not covered by Medicaid. 6. Prosthetics/Orthotics when placed at the time of surgery. 7. Other Specialty Out-Patient Services.
