Nevada Medicaid and Nevada Check Up News (Third 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

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 August 2024 Professional Claims. See Web Announcement 3448.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Second Quarter of 2024. See Web Announcement 3427.

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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... , including Personal Care and Adult Day Health Care services, for a recipient who chooses to enroll with a D-SNP program. The two dual eligible categories participating in ...
Terms matched: 1  -  Score: 20  -  01 Feb 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2701_20220201.pdf
... error for recipients with Dental Benefits Administrator benefits through the dental Managed Care Organization (MCO) have been reprocessed automatically. Results of the reprocessed claims appear on the ...
Terms matched: 1  -  Score: 23  -  31 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2696_20220131.pdf
... Type in their answer to 4 the Challenge Question to verify 5 identity 4. Choose whether log in is on a personal computer or public computer 5. Click ...
Terms matched: 1  -  Score: 72  -  28 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Dental_and_Orthodontia_Training_2021.pdf
... from diagnosis list. ii. If the disorder or diagnosis is not listed, choose “Otherâ€and enter a diagnosis in the “If Other ...
Terms matched: 1  -  Score: 13  -  28 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
... also be opting out of receiving paper Medicaid cards and notifications in the future. Choose the desired language. Nevada Medicaid Provider Training Proprietary and Confidential 8 Registering for ...
Terms matched: 1  -  Score: 39  -  26 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NVMedicaid_Application_Provider_Guide.pdf
... providers. The user will need to choose the correct provider and click on the ... ) recipients, Managed Care Organization (MCO) recipients or both FFS and MCO ...
Terms matched: 2  -  Score: 56  -  25 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Revalidation_and_Change_(Individual).pdf
... providers. The user will need to choose the correct provider and click on the ... ) recipients, Managed Care Organization (MCO) recipients or both FFS and MCO ...
Terms matched: 2  -  Score: 56  -  25 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Revalidation_and_Change_(Group).pdf
... Type from the drop-down menu. Select Choose File and locate the appropriate document for ... ) recipients, Managed Care Organization (MCO) recipients or both FFS and MCO ...
Terms matched: 2  -  Score: 44  -  25 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_(Individual).pdf
... Type from the drop-down menu. Select Choose File and locate the appropriate document for ... ) recipients, Managed Care Organization (MCO) recipients or both FFS and MCO ...
Terms matched: 2  -  Score: 44  -  25 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_(Group).pdf
... need to be changed. Select the Attachment Type from the drop-down menu. Select Choose File and locate the appropriate document for uploading. Once the document is placed ...
Terms matched: 1  -  Score: 12  -  25 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_(Emergency-Individual).pdf
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