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.

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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.

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... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_2014-0918.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_2013-0812.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_06-15.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Anticoagulants_03192013.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Anticoagulants_092212.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 44  -  20 Sep 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20210902.pdf
... Date: 01/02/09 Web Announcement 239 Managed Care Organization (MCO) Changes: DHCFP Contracts with AMERIGROUP; No Change to Health Plan of ...
Terms matched: 1  -  Score: 44  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_239_010209.pdf
... legal or voluntary hold. All Nevada Medicaid recipients, including Managed Care Organization (MCO) enrolled recipients, are eligible if the above conditions are met. The ...
Terms matched: 1  -  Score: 44  -  19 Jul 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT35_Spec_987.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 44  -  07 Sep 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20210825.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 44  -  24 Aug 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20210820.pdf
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