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]

Notifications

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 May 2024 Professional Claims. See Web Announcement 3382.

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.

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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... Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. You will also not have access to the Provider Web ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1265_20161110.pdf
... Ill (SMI) may elect to disenroll from the Medicaid Managed Care Organization (MCO) program. However, the recipient must be redetermined as SED or SMI ...
Terms matched: 1  -  Score: 87  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_301_20091230.pdf
... Churchill. Coordinator who is responsible for developing his or her Individual Support Recipients who choose self-directed services Plan (ISP) . will be assisted by a Financial Management ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT38_20090501.pdf
... when a managed care recipient is allowed to switch from one Managed Care Organization (MCO) to the other. Previously, a recipient (with no other household ...
Terms matched: 1  -  Score: 102  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_655_20131021.pdf
... date for the exiting agency. Recipients who request a transfer but require assistance to choose a new agency will be directed to their local Nevada Medicaid District Office for ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_759_20140623.pdf
... scheduled for following month after the recipient has transitioned to a Managed Care Organization (MCO) . Commencing with date of service June 1, 2005, we will ...
Terms matched: 1  -  Score: 36  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_50_041805.pdf
... To complete changes online, please login to the secure Provider Web Portal, and choose “Revalidate-Update Providerâ€or use the Provider Information Change Form (FA-33 ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1107_20160328.pdf
... complete provider changes online, please login to the secure Provider Web Portal, and choose “Revalidate-Update Providerâ€or use the Provider Information Change Form (FA-33 ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1114_20160406.pdf
... 27, 2017 Announcement 1331 Attention All Nevada Medicaid Providers: Managed Care Organization (MCO) Changes Effective 2017 Effective July 1, 2017, the Division of Health ...
Terms matched: 1  -  Score: 168  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1331_20170327.pdf
... Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. ï ‚ The provider will need to submit a new ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1205_20160816.pdf
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