Nevada Medicaid COVID-19
Nevada Health Response
Due to scheduled system maintenance, the following functionalities will be unavailable from 7 a.m. to 9 a.m. Pacific Time Sunday, October 24, 2021:
- Trading Partner File Transfer (EDI/SFTP)
- Business Partner File Transfer (EDI/SFTP)
After the upgrade, users with automated processes who have an issue connecting will need to log in manually and accept a banner notification. This is a one-time event. For information or any issues after the upgrade, please contact: email@example.com or (877) 638-3472 Option 2, Option 0, Option 3.
Known Modernization System Issues-Click HERE
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 March 2021 Claims. Web Announcement 2472
Top Prior Authorization Denial Reasons for the First Quarter of 2021. See Web Announcement 2505
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