Nevada Medicaid and Nevada Check Up News (First Quarter 2024 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

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Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.

Unwinding COVID-19 Information

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 April 2024 Professional Claims. See Web Announcement 3361.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See Web Announcement 3280.

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.

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1641. web_announcement_276_20090720.pdf
... . Please ensure that each request is complete and provides an accurate list of service codes, units, provider NPIs/APIs and dates of service. Failure to ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_276_20090720.pdf
1642. web_announcement_370_20101206.pdf
... The 2010 ICD-9-CM emergency diagnosis codes covered by Nevada Medicaid have been updated in the Medicaid Management Information System (MMIS) effective with dates of service on or ...
Terms matched: 1  -  Score: 115  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_370_20101206.pdf
1643. NV_BillingGuidelines_PT11_online_012706.pdf
... @fhsc.com if you have questions regarding coverage or requirements for a specific service or code. Prior Authorization Requirements To request prior authorization, use form FH-3 or FH-8 ...
Terms matched: 1  -  Score: 108  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_012706.pdf
1644. web_announcement_32_080404.pdf
... Claim Form FH-40) by Sept. 30, 2004. Form submittal instructions and ... in error due to Medicare -related edit codes, (1 ) note the edit ...
Terms matched: 2  -  Score: 55  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_32_080404.pdf
1645. web_announcement_931_20150616.pdf
... , as training time and space is very limited, it has been requested by ... 21 October 21 â€" October 23 In an effort to maximize state resources ...
Terms matched: 2  -  Score: 42  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_931_20150616.pdf
1646. NV_BillingGuidelines_PT65_online_20140409.pdf
... face-to-face encounter must occur no more than 30 calendar days prior to the third benefit ... : 2310E NM101 = 77 Entity Identifier Code 2310E NM102 = 2 Non-Person Entity 2310E ...
Terms matched: 2  -  Score: 55  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT65_online_20140409.pdf
1647. Sodium-glucose_2016-12.pdf
... . 2012;156:405-415. 30. HÃ ring HU, Merker L ... 97(3 ): 1020-31. 23. Strojek K, Yoon KH, ...
Terms matched: 2  -  Score: 23  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Sodium-glucose_2016-12.pdf
1648. web_announcement_1210_20160824_570602_08252016.pdf
... City, County or Zip Code is very useful in ... your search results. ï ‚ The beginning part of ... Provider Web Portal On August 23, 2016, the ...
Terms matched: 3  -  Score: 76  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1210_20160824_570602_08252016.pdf
1649. NV_EnrollmentChecklist_PT38_Spec_216_n061215.pdf
... " Individuals with Intellectual Disabilities and Related Conditions Specialty 216: Supported Living Services Specialty code 216: Supported Living Services includes any of the following services: RESIDENTIAL SUPPORT ...
Terms matched: 1  -  Score: 26  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT38_Spec_216_n061215.pdf
1650. web_announcement_814_20141010.pdf
... NPI of the OPR provider on their claim: 16, 17, 19, 23, 27, 29, 33, 34, 37, 43, 45 ...
Terms matched: 1  -  Score: 23  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_814_20141010.pdf
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