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

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 6 p.m. to midnight Pacific Time Sunday, May 19, 2024, 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
  • Trading Partner File Transfer (EDI/SFTP)
  • Business Partner File Transfer (EDI/SFTP)

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 March 2024 Professional Claims. See Web Announcement 3335.

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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During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

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451. Fibric_Acid_Derivatives_2013-0812.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Fenofibrate Dose adjustment Renal dose Safety and C Unknown; not may be ...
Terms matched: 1  -  Score: 11  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Fibric_Acid_Derivatives_2013-0812.pdf
452. GnRH_LHRH_Agonists_2018_0312.pdf
... and Léger 2008) . â — ‹ These manifestations consist primarily of breast development in girls and testicular enlargement in boys (Carel and Léger ...
Terms matched: 1  -  Score: 78  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/GnRH_LHRH_Agonists_2018_0312.pdf
453. Growth hormone 2014 11.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Somatropin Safety and efficacy in Not studied in Not studied in B Unknown ...
Terms matched: 1  -  Score: 37  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Growth%20hormone%202014%2011.pdf
454. Growth Hormone.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Somatropin Safety and efficacy in Not studied in Not studied in B Unknown ...
Terms matched: 1  -  Score: 21  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Growth%20Hormone.pdf
455. Growth_Hormone_2017-09.pdf
... The clinical considered. significance of Unknown this decrease is whether unknown. excreted in breast milk; use with caution. *Pregnancy Category B = No evidence of ...
Terms matched: 1  -  Score: 12  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Growth_Hormone_2017-09.pdf
456. Growth_Hormone_2013-0812.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Somatropin Safety and efficacy in Not studied in Not studied in B Unknown ...
Terms matched: 1  -  Score: 21  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Growth_Hormone_2013-0812.pdf
457. Hepatitis c antivirals 2014 11.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Ribavirin No dosage adjustment Not No dosage X Unknown; required in the ...
Terms matched: 1  -  Score: 11  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hepatitis%20c%20antivirals%202014%2011.pdf
458. Hepatitis C Protease Inhibitors.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Boceprevir Safety and efficacy in No dosage No dosage B* Unknown; ...
Terms matched: 1  -  Score: 11  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hepatitis%20C%20Protease%20Inhibitors.pdf
459. Hepatitis_C_Antivirals_2013-0812.pdf
... and Precaution Generic Elderly/ Renal Hepatic Pregnancy Excreted in Name Children Dysfunction Dysfunction Category Breast Milk Ribavirin No dosage adjustment Not No dosage X Unknown; required in the ...
Terms matched: 1  -  Score: 11  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hepatitis_C_Antivirals_2013-0812.pdf
460. Hepatitis_C_Antivirals_and_Combinations,_Direct_Acting_2015-0930.pdf
... and Precaution Generic Renal Hepatic Pregnancy Excreted in Name Elderly/Children Dysfunction Dysfunction Category Breast Milk Single Entity Products Daclatasvir No evidence of No dosage No dosage No data ...
Terms matched: 1  -  Score: 23  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hepatitis_C_Antivirals_and_Combinations,_Direct_Acting_2015-0930.pdf
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