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 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 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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... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 253  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20150701.pdf
... (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  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Selective_Serotonin_(5-HT1)_Agonists_2013-0812.pdf
... stroke: no therapy is suggested over antithrombotic therapy. For Therapy and patients who choose antithrombotic therapy, aspirin is suggested over Prevention of oral anticoagulation or combination therapy ...
Terms matched: 1  -  Score: 53  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Platelet_Inhibitors_2013-0812.pdf
... recipient or his/her guardian may choose to send an appeal to the DHCFP ... Dates of eligibility • Which MCO (or “HMOâ€) ...
Terms matched: 2  -  Score: 129  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_online_2005-12-29_to_2007-08-09.pdf
... Managed Care .... 18 Fee For Service.... 18 Managed Care .... 18 MCO Contact Information .... 18 Health Plan of Nevada (HPN) .... ...
Terms matched: 1  -  Score: 315  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_online_2007-08-09_to_2008-08-08.pdf
... of discontinuation symptoms than other SSRIs. o Take into account toxicity in overdose when choosing an antidepressant for people at significant risk for suicide. Be aware that compared ...
Terms matched: 1  -  Score: 21  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Serotonin%20and%20Norepinephrine%20Reuptake%20Inhibitors_2014_0811.pdf
... program is a rehabilitation program for recipients by request. TRUE or FALSE 2. Choose the service not covered under the PCS program. a. Bathing and Dressing ...
Terms matched: 1  -  Score: 12  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PCS_Presentation_2012_ver1_0_050712.pdf
... (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  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Selective_Serotonin_(5-HT1)_Receptor_Agonists_2013-0510.pdf
... during the first two weeks of therapy; therefore, this must be considered when choosing 10 an agent for the acute treatment of schizophrenia. Lurasidone is indicated for ...
Terms matched: 1  -  Score: 70  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Atypical_Antipsychotics_2013-0812.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 248  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20160202.pdf
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