January, February and March 2014 Provider Training Reminder [Web Announcement 679]
Attention Pharmacies: Claims adjudication process to validate ordering, prescribing and referring (OPR) practitioners [Web Announcement 702]
Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2013 Provider Newsletter [Read]
Provider Web Portal Quick Reference Guide (Updated April 16, 2012)
Web Announcement 706
Attention Provider Types 12, 17, 20, 24, 25 and 77 Regarding Claims Recouped in Error
Update to Web Announcement 669: All previously paid claims that inappropriately denied, i.e. recouped, for edit code 4583 (Current procedure is experimental) have been reprocessed. The recoupments appeared on remittance advices dated November 8, 2013, and November 15, 2013. The adjudication of the reprocessed claims appears on remittance advices dated February 28, 2014.
Web Announcement 705
Policy for Habilitation Services for EPSDT
Habilitation services are provided in order for a person to attain, maintain or prevent deterioration of a skill or function never learned or acquired due to a disabling condition.
Medically necessary therapy services (Occupational, Physical and Speech/Communication) provided by provider types 12 (Hospitals, Outpatient), 60 (School Based Services) and 34 (Therapy) under the EPSDT program include habilitation services for individuals under the age of 21.
Web Announcement 704
Claim Form Instructions Online for New CMS-1500 (02-12) and 2012 ADA Claim Forms
Claim form instructions for the new CMS-1500 (02-12) and 2012 American Dental Association (ADA) claim forms are now available on this website on the Provider Billing Information webpage. Please review the instructions and the field requirements.
Nevada Medicaid began accepting the CMS-1500 (02-12) claim form and the 2012 ADA claim form on January 2, 2014. A three-month dual-use period of the CMS-1500 (version 08/05) and the 2006 ADA forms and the new forms is in effect through March 31, 2014. Claims received by HP Enterprise Services on or after April 1, 2014, must be on the new CMS-1500 (02-12) and 2012 ADA claim forms. Effective April 1, 2014, the CMS-1500 (version 08/05) and the 2006 ADA will be returned to providers.
Web Announcement 703
Provider Enrollment Fax Number Updated on EVS “Contact Us” Webpage
The “Contact Us” webpage that is available when providers are logged in to the Electronic Verification System (EVS) has been updated with the new fax number for the HP Enterprise Services (HPES) Provider Enrollment Unit. Please be sure to use the following fax number to contact the Provider Enrollment Unit: (775) 335-8593.
To access the “Contact Us” webpage before and after logging in to EVS, please click on the “Contact Us” link that appears in the top right corner of the page.