Attention Provider Types 12 and 17: Prior Authorization Required for Therapy Services [See Web Announcement 574]
2013 Provider Training Registration Form
Provider Web Portal Quick Reference Guide (Updated April 16, 2012)
Provider Exclusions, Sanctions and Press Releases
Web Announcement 612
URGENT UPDATE: Payment Delay for Certain Claims
It is anticipated that there will be a delay in claims payment for Nevada Check Up recipients as well as certain Medicaid recipients. June 21 and June 28 are the weeks that payment for certain claims may be delayed due to State Budgetary time frame issues. Any delay in claims payment with an edit of "in Review by DHCFP" will be released on July 5, 2013.
Web Announcement 611
Payment Delay for Claims for Nevada Check Up Recipients
It is anticipated that there will be a delay in the June 14, 2013, payments for certain Nevada Check Up eligible recipients. The delay in payment is for a one-week period. Any claims that pended due to insufficient budget authority will be released for payment the following week.
Web Announcement 610
URGENT Message Regarding Claims Denied June 6 and June 7, 2013, for Edit Code 0883 (Updated June 11, 2013)
Due to an unexpected issue, all CMS-1500 (Professional), ADA (Dental) and Medicare Part B crossover claims received by HP Enterprise Services on June 6 and June 7, 2013, denied incorrectly for edit code 0883 (NPI/API submitted is invalid). The denial messages for the affected claims will appear on remittance advices (RAs) dated June 14, 2013.
The system issue has been corrected, and affected claims will be automatically reprocessed. The adjudication of the reprocessed claims will appear on RAs dated June 21, 2013. No action is required by providers.
Web Announcement 609
June 2013 Provider Training Courses
The HP Enterprise Services (HPES) training team will present the following virtual room courses in June 2013:
- Program Integrity: This workshop provides information about the three distinct programs DHCFP has to assist in ensuring the fiscal integrity of the programs it administers: the Surveillance and Utilization Review (SUR), the Payment Error Rate Measurement (PERM) program and the Financial and Compliance Audit program.
- Introduction to Becoming a Nevada Medicaid Provider: This workshop is reserved for those not enrolled with Nevada Medicaid at this time and are thinking of becoming providers of service for the Medicaid program.
- Understanding Eligibility: This workshop will assist providers in understanding the eligibility screens for Medicaid recipients on the Provider Web Portal’s prior authorization system.
- New CMS-1500 Claim Form Instructions: This workshop will assist providers in completing the CMS-1500 Claim Form using the updated instructions.
- New UB-04 Claim Form Instructions: This workshop will assist providers in completing the UB-04 Claim Form using the updated instructions.
- Quarterly Training for Medicaid Providers: This workshop will provide the updates and changes that are occurring in Nevada Medicaid and Nevada Check Up.
Please review the Provider Training Calendar for days and times, and register now by using the 2013 Provider Training Registration Form (FA-41). All times indicated are Pacific Time (PT). For questions, contact the HPES Training Department at NevadaProviderTraining@hp.com or (877) 638-3472, option 2, then option 0, then option 4.
Web Announcement 608
Medicaid Services Manual Updated
The following Medicaid Services Manual (MSM) chapter changes were approved at a recent Division of Health Care Financing and Policy (DHCFP) Public Hearing. The changes were approved on May 16, 2013. Please review the updated MSM chapters on the DHCFP website.
- MSM Chapter 600 – Physician Services
- MSM Chapter 1200 – Prescribed Drugs
- MSM Chapter 1500 – Healthy Kids Program
- MSM Chapter 2300 – Physical Disability Waiver
- MSM Chapter 3400 – Telehealth Services
The schedule and agendas for future hearings are on the DHCFP’s Public Notices webpage.