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]

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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 September 2024 Professional Claims. See Web Announcement 3465.

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

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

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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281. PT_39_ADHC_Training_061518.pdf
... Medicaid Adult Day Health Care Provider Training 36 Delegate Assignment, continued †' Choose the Functions you want the delegate to be able to perform †' ...
Terms matched: 1  -  Score: 26  -  25 Jun 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_39_ADHC_Training_061518.pdf
282. web_announcement_1629_20180628.pdf
... 834 Benefit Enrollment and Maintenance, which are used by the Managed Care Organization (MCO) Trading Partners. (Outbound files are those sent from Nevada Medicaid to ...
Terms matched: 1  -  Score: 21  -  29 Jun 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1629_20180628.pdf
283. NV_EDI_Trading Partner User Guide.pdf
... Options This section describes the connectivity options from which a Trading Partner will need to choose for the submission of transactions. Nevada Medicaid supports multiple methods for exchanging electronic ...
Terms matched: 1  -  Score: 68  -  06 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EDI_Trading%20Partner%20User%20Guide.pdf
284. NV_BillingGuidelines_PT43_20180829.pdf
... EPSDT) program. Managed Care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  29 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20180829.pdf
285. NV_BillingGuidelines_PT43_20170322.pdf
... the EPSDT program. Managed care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  29 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20170322.pdf
286. NV_Billing_General_20180108.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: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180108.pdf
287. NV_Billing_General_20180201.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: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180201.pdf
288. NV_Billing_General_20170901.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: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170901.pdf
289. Provider_Enrollment_and_Program_Integrity_Conference_Presentation.pdf
... Service Medicaid o Ensures all applicable ACA screenings are completed prior to enrolling in an MCO network o Network providers are not required to see FFS recipients 12 Division of ...
Terms matched: 1  -  Score: 20  -  21 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_and_Program_Integrity_Conference_Presentation.pdf
290. Multiple_Sclerosis_Agents_2018-11.pdf
... and published resources when making medical decisions. â — ‹ For active RRMS, choosing among the wide range of available drugs from the modestly effective to the highly ...
Terms matched: 1  -  Score: 23  -  09 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2018-11.pdf
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