Nevada Medicaid and Nevada Check Up News (Fourth 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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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 January 2025 Professional Claims. See Web Announcement 3559.

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

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2024. See Web Announcement 3458.

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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70 results found containing all search terms. 710 results found containing some search terms.

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1. NV_Billing_General.pdf
... 2025 30 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 199  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
2. NV_EVS_User_Manual_Ch2.pdf
... the Nevada Medicaid and Nevada Check Up program as well as Managed Care Organizations (MCO) and Third Party Liability (TPL) . The eligibility request is sent ...
Terms matched: 1  -  Score: 130  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch2.pdf
3. NV_Provider_Enrollment_Information_Booklet.pdf
... , procuring a vendor that providers can choose to utilize, but also allows providers ... program-integrity/index.html Managed Care Organization (MCO) Network Providers: • ...
Terms matched: 2  -  Score: 52  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Information_Booklet.pdf
4. Error_Code_to_EOB_to_ANSI.pdf
... Identification Segment (loop 2110 Service Payment Information REF), if present. 3365 MCO PAID DATE IS INVALID 1644 MCO Paid Date is Invalid. 16 Claim/ ...
Terms matched: 1  -  Score: 22  -  13 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
5. Known_Issues.pdf
... 1 /2019 6/25/2019 Managed Care, Managed Care Organization (MCO), all details on NDC (National outpatient or outpatient cross-over claims are ...
Terms matched: 1  -  Score: 40  -  25 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
6. NV_Billing_General_20250205.pdf
... 2024 32 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  21 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250205.pdf
7. web_announcement_3559_20250220.pdf
... claim to the appropriate by HMO Plan Nevada Medicaid HMO/Managed Care Organization (MCO) for processing. Client eligibility can be verified within the EVS by reviewing ...
Terms matched: 1  -  Score: 20  -  20 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3559_20250220.pdf
8. Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
... the submitter for correction. (When resubmitting a rejected encounter claim, the same MCO ICN/TCN must be used on the corrected encounter claim.) The ...
Terms matched: 1  -  Score: 286  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
9. Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
... the submitter for correction. (When resubmitting a rejected encounter claim, the same MCO ICN/TCN must be used on the corrected encounter claim.) The ...
Terms matched: 1  -  Score: 269  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
10. Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
... the submitter for correction. (When resubmitting a rejected encounter claim, the same MCO ICN/TCN must be used on the corrected encounter claim.) The ...
Terms matched: 1  -  Score: 241  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
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