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]

Notifications

Multi-Factor Authentication Frequently Asked Questions

Unwinding COVID-19 Information

Known System Issues-Click HERE

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.

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

Monday
8:00PM - 12:00AM

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... (P value not reported) . When permitted to years of age with attacks choose between eletriptan and sumatriptan SC for subsequent treatment, 78% of vs migraine ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/5-HT1%20Receptor%20Agonists_2015-1002.pdf
... ) • Those receiving Targeted Case Management (TCM) • MCO enrollees • Nevada Check-Up enrollees (CHIP) • Emergency ...
Terms matched: 1  -  Score: 23  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/6_Health_Care_Guidance_Program_2014.pdf
... Expanded Call Center 2014 Annual Medicaid Conference 2015 Open Enrollment • Clients who choose to use the pre-screener and are determined potentially eligible for a Qualified Health Plan ...
Terms matched: 1  -  Score: 36  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/3_Division_of_Welfare_DWSS_2014.pdf
... • Advanced Practice Registered Nurses • Physician Forums with FFS and MCO • Prior Authorization Alignment between FFS and MCO • Health ...
Terms matched: 1  -  Score: 57  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/2_Medicaid_Program_Highlights_DHCFP_2014.pdf
... remain on the line and make a note of the verification number. NOTE: MCO Eligibility and eligibility verification number are provided at the end of the call. ...
Terms matched: 1  -  Score: 116  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/201306_Verifying_Eligibility.pdf
... 6386 VLBW 179 189 184 169 Rate 2.34% 2.48% 2.73% 2.65% MCO Live Births 6671 7955 8963 8363 VLBW 70 86 110 100 Rate 1.05% ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/2013_Care_Management.pdf
... acknowledge in writing that they understand their right to select a qualified provider of their choosing • Only qualified providers prescribe services within scope of their practice under ...
Terms matched: 1  -  Score: 13  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/2012_Behavorial_Health_Presentation_v1_0.pdf
... HMO Plan Nevada Medicaid Health Maintenance Organization (HMO)/Managed Care Organization (MCO) for processing. Client eligibility can be verified within the EVS by review ...
Terms matched: 1  -  Score: 20  -  26 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2021%20Issue%203_20240926.pdf
... claim to the appropriate Nevada by HMO Plan Medicaid HMO/Managed Care Organization (MCO) for processing. Client eligibility can be verified within the EVS by reviewing ...
Terms matched: 1  -  Score: 20  -  23 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3448_20240923.pdf
... Behavioral Health Centers, CCBHCs) needs to be enrolled with Managed Care Organizations (MCO) . See Web Announcement 2649 for more information about MCO enrollment. Claims ...
Terms matched: 1  -  Score: 114  -  05 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3432_20240905.pdf
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