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Balance Billing Laws in North Dakota

Your medical billing rights and protections in North Dakota.

North Dakota ND
No Dedicated State Law No Surprises Act: Applies

North Dakota does not have a comprehensive state balance billing law. Residents rely on federal No Surprises Act protections, effective January 1, 2022, which protect against surprise bills for emergency services and certain non-emergency care at in-network facilities.

Key Protections in North Dakota

Emergency services: Federal NSA limits cost-sharing for out-of-network emergency services to in-network amounts

Out-of-network at in-network facility: Surprise billing prohibited without advance consent for non-emergency services

Good faith estimate: Providers must give advance cost estimates to uninsured and self-pay patients

Filing Information

Filing Deadline

Within 1 year of receiving the bill for federal NSA disputes

File a Complaint
Online Complaint Portal
Insurance Commissioner
State Insurance Commissioner

Additional Notes

North Dakota consumers rely on federal No Surprises Act protections. The ND Insurance Department can provide guidance and assistance with complaints.

How to File a Complaint in North Dakota

1

Gather Your Documentation

Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.

2

File with the State Regulator

Submit your complaint to the North Dakota Insurance Department. Include all supporting documents and a clear description of the billing dispute.

File complaint with North Dakota Insurance Department
3

File with CMS if Federal Protections Apply

If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.

File with CMS No Surprises Help Desk
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