Urgent Notification

URGENT INFORMATION: Provider Types Required to Include NPI of Ordering, Prescribing and Referring (OPR) Provider on Claims: 16, 17, 19, 23, 27, 29, 33, 34, 37, 43, 45, 46, 55, 63, 64 and 68[Web Announcement 826]

Urgent Notification

CMS-1500 (02-12) Claim Form Must Be Used Effective May 3, 2014

Due to updates to field instructions, providers are encouraged to review the CMS-1500 (02-12) Claim Form Instructions.

  • In Field 24E, the Diagnosis pointers must be alpha characters.
  • In Field 30, the space is labeled as reserved for NUCC use, but the Balance Due is required.

Nevada Medicaid Contact List

General Information

Customer Service Center
Claim inquiries and general information
Mailing Address:
Customer Service
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472

Nevada Medicaid Central Office
State policy inquiries and Fair Hearing requests
Mailing Address:
1100 East William St.
Suite 102
Carson City, NV 89701
Phone: (877) 638-3472 and (775) 684-3600

Automated Response System (ARS)
Recipient eligibility, recent payments, claim status, and prior authorization information via phone
Phone: (800) 942-6511

Electronic Verification System (EVS)
Recipient eligibility, claim status, prior authorization status, provider payments

Note: For EVS, there can only be one provider administrator for each NPI/FEIN/zip code. The provider administrator must register as a “Provider” and will be responsible for creating delegates for that provider. If you do not know who is the provider administrator is in your office, call the Customer Service Center at (877) 638-3472.

Mailing Address

Mail claims (CMS-1500, UB and ADA), claim appeals, and other written correspondence to:

HP Enterprise Services
P.O. Box 30042
Reno, NV 89520-3042

For claim appeals, write "Attn: Claim Appeals" on the envelope. For claim inquiries and all other written correspondence, write "Attn: Customer Service" on the envelope.

Back to Top

Web Sites

Nevada Medicaid Web Site
Web announcements, billing manual, billing guidelines, forms, pharmacy information

https://www.medicaid.nv.gov

DHCFP Web Site
Medicaid Services Manual, rates, policy updates, public notices

http://dhcfp.nv.gov

Back to Top

Provider Training

Mailing Address:
Provider Training
P.O. Box 30042
Reno NV 89520-3042
E-mail: NevadaProviderTraining@hp.com

Back to Top

Electronic Billing

Mailing Address:
EDI Coordinator
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Electronic Billing")
Fax: (775) 335-8593
E-mail: NVMMIS.EDIsupport@hp.com

Back to Top

Managed Care Organizations (MCOs)

The Nevada Medicaid and Nevada Check Up contracted Managed Care Organizations (MCOs) are AMERIGROUP Community Care and Health Plan of Nevada.

AMERIGROUP Community Care
Provider Contracting
Phone: (702) 228-1308, ext. 59844

Provider Inquiry Line
(for eligibility, claims and pre-certification)
Phone: (800) 454-3730

Notification/Pre-certification
Phone: (800) 454-3730
Fax: (800) 964-3627

Claims Address
AMERIGROUP Community Care
Attn: Nevada Claims
P.O. Box 61010
Virginia Beach, VA 23466-1010

Health Plan of Nevada (HPN)
Provider Contracting
(800) 745-7065

Member Services
Phone: (800) 962-8074
Fax: (702) 240-6281

Claims Address
Health Plan of Nevada
P.O. Box 15645
Las Vegas, NV 89114

Back to Top

Provider Enrollment

Mailing Address:
Provider Enrollment
PO Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Provider Enrollment")
Fax: (775) 335-8593

Back to Top

Prior Authorization

Prior Authorization
Phone: (800) 525-2395
Fax: (866) 480-9903

Prior Authorization for Dental and Personal Care Aide

Mailing Address:
"Dental PA" or "PCA PA"
P.O. Box 30042
Reno, NV 89520-3042
Phone: (800) 525-2395
Dental Fax: (855) 709-6848
PCA Fax: (855) 709-6846

Prior Authorization for All Other Service Types (except Pharmacy)
Phone: (800) 525-2395
Fax: (866) 480-9903

Mail prior authorization appeals to:

HP Enterprise Services
Nevada Prior Authorization - Appeals
6511 SE Forbes Ave., Bldg. 283
P.O. Box 19287
Topeka, KS 66619-0287

Back to Top

Pharmacy

Customer Service Center
Pharmacy prior authorization requests
Phone: (855) 455-3311
Fax: (855) 455-3303

Technical Call Center
General pharmacy inquiries
Phone: (866) 244-8554

Pharmacy Web PA
Submit prior authorization requests online for prescription drugs. Select "Pharmacy Web PA Login" from the "Pharmacy" menu on this web site. This will take you to the EVS Login. After login, prescribers will see a link for Pharmacy PA.

Back to Top

Public Hearings

Providers are welcome to attend public hearings and voice their opinion on policy changes. Call the number below to receive electronic or written notices of scheduled public hearings.

Phone: (775) 684-3681

Back to Top

PASRR/LOC

Phone: (800) 525-2395
Fax: (855) 709-6847

Back to Top

Third Party Liability (TPL) Identification and Recovery

If you believe a recipient's private insurance records are incorrect, please contact Emdeon at:

Mailing Address:
Emdeon TPL Unit
P.O. Box 148850
Nashville TN 37214

Phone: (855) 528-2596
Fax: (855) 650-5753
Email: TPL-NV@Emdeon.com

Emdeon Subrogation Unit
Phone: (855)-528-2596
Fax: (855)-650-5753

If you believe a recipient's Medicare record is incorrect, please contact the DHCFP at:
Email: TPL@dhcfp.nv.gov

Back to Top

Electronic Health Records (EHR) Incentive Program

Customer Service Center
CGI Business Services
Phone: (888) 639-3452
Email:NEIPS.us.ipod@cgi.com

Back to Top

On this website and on documents posted herein:

Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes, descriptions and data are copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability for data contained or not contained on this website and on documents posted herein.

CPT is a registered trademark ® of the AMA. CDT is a registered trademark ® of the ADA. Applicable FARS/DFARS apply.

The Nevada Division of Health Care Financing adheres to all applicable privacy policies and standards, including HIPAA rules and regulations, regarding protected health information. Click here to see the State of Nevada Online Privacy Policy

Back to Top