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.

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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 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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65 results found containing all search terms. 688 results found containing some search terms.

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1. Binder_DUR_2019_0124.pdf
... really be controlled by the clinician who chooses to administer the product in his or ... : It would help to know which MCO you’re referring to. ...
Terms matched: 2  -  Score: 633  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2019_0124.pdf
2. MCO_FAQs_Recipients_101521_Fully_Remediated.pdf
... a managed care health plan, you choose a doctor to be your primary care ... Recipient General and Managed Care Organization (MCO) FAQ’s Updated 10 ...
Terms matched: 2  -  Score: 549  -  15 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/MCO_FAQs_Recipients_101521_Fully_Remediated.pdf
3. Binder_DUR_2019-0725.pdf
... Growth Hormone Managed Care Organization name: Choose an item. Please place a check ... we have similar limits to every other MCO and fee for service as well as ...
Terms matched: 2  -  Score: 490  -  18 Jun 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2019-0725.pdf
4. Binder_DUR_2018_0726.pdf
... what the choices between which agent to choose. There is no preference for the ... is when Medicaid recipient transfers from one MCO to another? Jim Marx: Right ...
Terms matched: 2  -  Score: 478  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2018_0726.pdf
5. Final_Introduction_to_Nevada_Medicaid_and_Check_Up_2012-0801.pdf
... €¢ Recipients have 30 days to choose an MCO before one is assigned to ... Program requires the mandatory enrollment in an MCO of some recipients found eligible for Medicaid ...
Terms matched: 2  -  Score: 470  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Final_Introduction_to_Nevada_Medicaid_and_Check_Up_2012-0801.pdf
6. web_announcement_3103_20230627.pdf
... the enrollees to have sufficient time to choose an MCO and return their letter to ... Nevada Check Up Managed Care Organization (MCO) 2023 Open Enrollment Managed Care Organization ...
Terms matched: 2  -  Score: 462  -  27 Jun 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3103_20230627.pdf
7. web_announcement_2834_20220706.pdf
... the enrollees to have sufficient time to choose an MCO and return their letter to ... Nevada Check Up Managed Care Organization (MCO) 2022 Open Enrollment Managed Care Organization ...
Terms matched: 2  -  Score: 462  -  06 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2834_20220706.pdf
8. NV_Billing_General_20191121.pdf
... 2019 34 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: 461  -  13 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20191121.pdf
9. NV_Billing_General_20200413.pdf
... 2019 34 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: 461  -  18 Nov 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20200413.pdf
10. NV_Billing_General_20231130.pdf
... 2023 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: 459  -  13 Mar 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20231130.pdf
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