NDHIN and ND Medicaid are separate agencies with separate patient information systems.  It is the policy of ND Medicaid to only accept claims communication through DSM. While health care facilities integrate DSM into their EHR, third-party billers may need to obtain their own DSM service; NDHIN does provide that service.  Communication with ND Medicaid is a use case for NDHIN's DSM service - Communicate. 

In today’s healthcare landscape, many facilities are outsourcing their invoicing and payment processes to third-party billing companies.  The business application of third-party billing reduces cost and improves compliance with industry regulations; both are advantages for the medical facility. But the use of third-party billers often transfers to the billing company the communication with payers about claims.

Electronic transfer of protected patient health information necessary to communicate with payers about claims is handled through certified EHRs. Third-party billing companies do not have EHRs, but they often need to send electronic patient information. NDHIN offers a service through which third-party billing companies can transfer protected patient health information safely and securely.

NDHIN Communicate is a DSM (Direct Secure Messaging) service certified for the electronic transfer of protected patient health information.  DSM is not the same as an encrypted or secure email which uses an ISP (internet service provider) to broker messages; DSM uses a HISP (Health Information Service Provider) which is an accredited network service operator. A HISP is a HIPAA compliant, interoperable transport method for protected health information.

IMPORTANT:  A normal ISP email like Gmail or a work email that is encrypted/secure cannot be received by a DSM mailbox and a DSM message cannot be received by a normal ISP email like Gmail.  DSM to DSM Is the only way it works.

Often, third-party billers obtain permission from the HCO (Health Care Organization) they bill for to use the HCO DSM service.  If the third-party biller is not able to use the HCO DSM service, the third-party billing company can contract with NDHIN to use NDHIN Communicate (NDHIN'S HISP and DSM service). To obtain more information about the NDHIN DSM service - Communicate, please inquire at