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
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... first 1 to 2 weeks of therapy; therefore, this must be considered when choosing an agent for 10 the acute treatment of schizophrenia. Lurasidone is indicated for ...
Terms matched: 1  -  Score: 59  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical%20(Second-Generation)%20Antipsychotics_07232012.pdf
... DHCFP that have swing bed licensure and certification. Requesting Authorization To request authorization: MCO vs. FFS ï ‚ Complete and fax form FA-3 or FA-8 as When ...
Terms matched: 1  -  Score: 58  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT75_20111111.pdf
... 2658 Attention All Providers: Recipient/Enrollee Webpage Created with Managed Care Organization (MCO) Expansion Information Effective immediately, a new webpage has been created on the ...
Terms matched: 1  -  Score: 58  -  17 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2658_20211217.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
... Presentation Presented to NV DUR Board on January 28, 2021 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 57  -  06 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_Jan_2021.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 56  -  16 Sep 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_September_2021.pdf
... the Direct Managed Care Enrollment process to enroll recipients into their Managed Care Organization (MCO) immediately upon approval of their Medicaid eligibility. This change will give Medicaid ...
Terms matched: 1  -  Score: 56  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1353_20170417.pdf
... for no prior authorization due to a change in eligibility from Managed Care Organization (MCO) to Fee-for-Service (FFS) after a newborn’s date of ...
Terms matched: 1  -  Score: 56  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_988_20150929.pdf
... in their answer to 4 the Challenge Question to verify identity. 5 4. Choose whether log in is on a personal computer or public computer. 5. ...
Terms matched: 1  -  Score: 56  -  12 Jun 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_13_Psychiatric_Hospital_Inpatient_Training_2019.pdf
... the DUR is the third from the top is ingredient duplication. We continue to choose a new topic for RetroDUR every quarter and send out letters each month. ...
Terms matched: 1  -  Score: 55  -  17 Dec 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Jan_2020.pdf
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