Nevada Medicaid and Nevada Check Up News (First Quarter 2025 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: Known Issue with Resubmitting Returned to Provider (RTP) Applications
This issue has been resolved, and the impacted applications have been placed in the appropriate status for review.

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Attention Provider Types 24, 72, 74, and 77:
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Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2025 Professional Claims. See Web Announcement 3593.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2024. See Web Announcement 3458.

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211. NV_BillingGuidelines_PT19_20090325.pdf
... in a Managed • Revenue code 0123: NF Pediatric Care Organization (MCO) upon Specialty Care I or NF Pediatric admission, that MCO is responsible ...
Terms matched: 1  -  Score: 35  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT19_20090325.pdf
212. web_announcement_363_20101101.pdf
... beginning Jan. 1, 2011, but may start the process immediately if they choose to do so. The re-enrollment requirement does not apply to providers who enrolled ...
Terms matched: 1  -  Score: 23  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_363_20101101.pdf
213. NV_BillingGuidelines_PT22_20100120.pdf
... transitioned to a Managed Care Effective with dates of service on or after Organization (MCO) at the beginning of July 1, 2009, for Nevada Check Up ...
Terms matched: 1  -  Score: 79  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20100120.pdf
214. NV_BillingGuidelines_PT10_20100701.pdf
... menu) . Managed Care Hospitals may provide services to Medicaid Managed Care Organization (MCO) recipients but must request reimbursement from the MCO. There are no carve-outs ...
Terms matched: 1  -  Score: 36  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT10_20100701.pdf
215. NV_Provider_Enrollment_Instructions.pdf
... Home and Community Based Assisted Living Waiver 60 School Based 62 Managed Care Organization (MCO) 63 Residential Treatment Center (RTC) 64 Hospice 65 Hospice, Long ...
Terms matched: 1  -  Score: 12  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Instructions.pdf
216. NV_BillingGuidelines_PT54_20050601.pdf
... through evaluation, a recipient may elect to disenroll from the Managed Care Organization (MCO) . The MCO is required to notify DHCFP of such election. If ...
Terms matched: 1  -  Score: 104  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT54_20050601.pdf
217. NV_BillingGuidelines_PT54_20100219.pdf
... with SED or Prior Authorization Requirements SMI chooses to disenroll from the MCO. ( ... weekly or monthly. Care Organization (MCO) enrollment is mandatory, may disenroll ...
Terms matched: 2  -  Score: 134  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT54_20100219.pdf
218. SR-100_20111123.pdf
... online to get the challenge questions, it asked me a question I did not choose. Remember, the Provider Web Portal will not be active until December 5 ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SR-100_20111123.pdf
219. web_announcement_104_092806.pdf
... Date: 09/28/06 Web Announcement 104 Managed Care Organization (MCO) Changes The Division of Health Care Financing and Policy (DHCFP) is ...
Terms matched: 1  -  Score: 42  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_104_092806.pdf
220. NV_BillingGuidelines_PT22_20090801.pdf
... and recipient is transitioned to a Managed Care routine maintenance to promote dental Organization (MCO) at the beginning of health. their second full month of eligibility. ...
Terms matched: 1  -  Score: 100  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20090801.pdf
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