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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NOTIFICATION:The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, January 26, 2025, for scheduled maintenance:
  • Secure Provider Web Portal (Electronic Verification System – EVS), which includes:
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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 December 2024 Professional Claims. See Web Announcement 3538.

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

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

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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91. Binder_DUR_2016_01.pdf
... are widely available through our distributor, so I do believe it could be the MCO that is mandating this. Coleen Lawrence: This Board is only responsible for ...
Terms matched: 1  -  Score: 14  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2016_01.pdf
92. Binder for Jan 22 DUR Meeting 2015-0114.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 75  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder%20for%20Jan%2022%20DUR%20Meeting%202015-0114.pdf
93. Binder_DUR_2015_09.pdf
... than welcome to do whatever the Board chooses to do. You could do the ... and not to be confused with an MCO or Managed Care Organization. We serve ...
Terms matched: 2  -  Score: 47  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2015_09.pdf
94. Beta-adrenergic_antagonists_2015-0812.pdf
... of the level of urine albumin excretion. Â In adult kidney transplant recipients, choose a blood pressure -lowering agent after taking into account the time after transplantation, ...
Terms matched: 1  -  Score: 21  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Beta-adrenergic_antagonists_2015-0812.pdf
95. Benefit_Enrollment_and_Maintenance_(834)_-_Mod.pdf
... Daily files will be generated if DHCFP has updates for a recipient enrolled in an MCO. If no updates are performed, then no enrollment file will be generated ...
Terms matched: 1  -  Score: 46  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834)_-_Mod.pdf
96. Benefit_Enrollment_and_Maintanance_(834)_n062818.pdf
... Daily files will be generated if DHCFP has updates for a recipient enrolled in an MCO. If no updates are performed, then no enrollment file will be generated ...
Terms matched: 1  -  Score: 43  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintanance_(834)_n062818.pdf
97. Behavioral_Health_Training_041618.pdf
... Authorization Forms, continued †' While on the Forms page, locate and choose appropriate forms †' Make sure that you follow the instructions on each ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Behavioral_Health_Training_041618.pdf
98. Atypical (Second-Generation) Antipsychotics_07232012.pdf
... first 1 to 2 weeks of therapy; therefore, this must be considered when choosing an agent for 10 the acute treatment of schizophrenia. Lurasidone is indicated for ...
Terms matched: 1  -  Score: 59  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical%20(Second-Generation)%20Antipsychotics_07232012.pdf
99. Atypical (Second-Generation) Antipsychotics.pdf
... first 1 to 2 weeks of therapy; therefore, this must be considered when choosing an agent for 10 the acute treatment of schizophrenia. Lurasidone is indicated for ...
Terms matched: 1  -  Score: 59  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical%20(Second-Generation)%20Antipsychotics.pdf
100. Antiemetics_(5-HT3_Antagonist_and_Combinations)_02-10-15.pdf
... Choice of agents generally depends upon the relative emetogenic potential of the regimen. When choosing among a class of agents, guidelines have suggested that all 5-HT3 receptor antagonists ...
Terms matched: 1  -  Score: 10  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antiemetics_(5-HT3_Antagonist_and_Combinations)_02-10-15.pdf
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