URGENT NOTIFICATION: Physician Administered Drug (PAD) claims may be experiencing a host eligibility error. The impacted claims will be reprocessed automatically. No action is needed by providers.
NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, December 3, 2023, for scheduled maintenance:
- Secure Provider Web Portal (Electronic Verification System – EVS), which includes:
- Recipient Eligibility
- Provider Claim Appeals
- Prior Authorization (PA) system
- Claims Submission
- Online Provider Enrollment (OPE)
- Gabby®, which includes:
- Customer Service Center (877) 638-3472
- Automated Response System (ARS) (800) 942-6511
- Real time CAQH/CORE EDI eligibility and claim verification
- Provider PASRR
Nevada Medicaid COVID-19
Nevada Health Response
Known System Issues-Click HERE
Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System
Survey
Paper claims are no longer accepted by Nevada Medicaid. Please refer to
Web Announcement 1733 and
Web Announcement 1829 for additional information.
Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2023 Professional Claims. See
Web Announcement 3221.
Top Prior Authorization Denial Reasons for the Third Quarter of 2023. See
Web Announcement 3227.
Top 10 Enrollment Return Reasons and Resolutions for First Quarter 2021 Submissions. See
Web Announcement 2501.
Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at
dhcfp.nv.gov and the Billing Guide for your provider type at
www.medicaid.nv.gov.
