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]


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 and the Billing Guide for your provider type at

Scheduled Site Maintenance

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.

Monday - Friday
12:00AM - 12:30AM

8:00PM - 12:00AM

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... . In either case, co-prescribe with a proton pump inhibitor (PPI), choosing the one with the lowest acquisition cost. • All oral NSAIDs ...
Terms matched: 1  -  Score: 21  -  15 Jun 2017  -  URL:
... 2 Diabetes Awareness Page 3 Billing Tips/Reminders Page 2 PERM Update Page 3 MCO Work Group Page 4 Nevada Medicaid News Updates on Major Issues NPI/API ...
Terms matched: 1  -  Score: 38  -  15 Jun 2017  -  URL:
... alone. of disease flares and  A variety of factors should be considered when choosing a particular use of adjunctive topical corticosteroid for the treatment of AD, including ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL:
... in a Managed Care and/or respiratory therapists’ drawing of Organization (MCO), it is the laboratory’s arterial blood. responsibility to ...
Terms matched: 1  -  Score: 38  -  15 Jun 2017  -  URL:
... Service (FFS) When a recipient is enrolled in a Managed Care Organization (MCO), request PA from and submit claims to the MCO. For recipients ...
Terms matched: 1  -  Score: 37  -  15 Jun 2017  -  URL:
... has Medicaid coverage through one of the managed care organizations, then contact the appropriate MCO for prior au- thorization and billing instructions: Amerigroup Community Care (800 ...
Terms matched: 1  -  Score: 12  -  15 Jun 2017  -  URL:
... June 15, 2005, and offers 4 (four) options for providers to choose in order to meet this requirement. All providers with a negative balance will ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL:
... June 14, 2006 â€" Medicaid Health Services’ promotion of Electronic choose to attend only those classes that for Managers, Medicaid for Admitting & Data ...
Terms matched: 1  -  Score: 12  -  15 Jun 2017  -  URL:
... by Managed Care Organizations (MCOs) . If a recipient is enrolled in an MCO, you must bill the MCO directly. If the recipient is enrolled in ...
Terms matched: 1  -  Score: 35  -  15 Jun 2017  -  URL:
... White Pine, Lander, Eureka, Humboldt, Pershing and Churchill. Recipients who choose self-directed services will be assisted by a Financial Management Service staff and a Support ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL:
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