Welcome to Health Information Designs' North Dakota Department of Human Services Prior Authorization Web site.
On this site you will find all of the forms needed to request a Prior Authorization. Please download the proper form, and fill it out COMPLETELY. You can fax the completed form to 1-866-254-0761, or e-mail it to firstname.lastname@example.org. If you need further assistance, please contact us at 1-866-773-0695.
You can now fill out forms online in our new interactive section. Just click on PA Forms on the left of the screen.
For other information regarding North Dakota Department of Human Services, click here.
Most of the documents on this site are in .pdf format. In order to download and print these documents correctly, we recommend downloading and installing the latest version of Adobe Acrobat Reader.
All attempts are made to have the most current information on this Web site. However, the information on this Web site is NOT a guarantee of current policy or limits. Application of current policy and limits will occur when the claim is processed.