Nevada Medicaid and Nevada Check Up News (First 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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Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.

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 March 2024 Professional Claims. See Web Announcement 3335.

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

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See Web Announcement 3280.

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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21. web_announcement_3245_20231220.pdf
... €™s service limits are met. • For a provider who chooses to submit a PA request when the recipient has not exhausted their service limitations ...
Terms matched: 1  -  Score: 21  -  20 Dec 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3245_20231220.pdf
22. NV_BillingGuidelines_PT17_Specialty_188_20220118.pdf
... to pay CCBHCs providing services under a contract with a Medicaid Managed Care Organization (MCO; also known as a Managed Care Entity [MCE]) additional payments ...
Terms matched: 1  -  Score: 23  -  06 Dec 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_188_20220118.pdf
23. NV_BillingGuidelines_PT17_Spec188.pdf
... to pay CCBHCs providing services under a contract with a Medicaid Managed Care Organization (MCO; also known as a Managed Care Entity [MCE]) additional payments ...
Terms matched: 1  -  Score: 23  -  06 Dec 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec188.pdf
24. web_announcement_3229_20231201.pdf
... . Electronic 1099s will be available starting with the 2023 tax year. Providers that choose not to obtain their 1099s electronically can also use the EVS Demographic Updates feature ...
Terms matched: 1  -  Score: 21  -  01 Dec 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3229_20231201.pdf
25. NV_Billing_General_20230523.pdf
... 2023 32 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  01 Dec 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20230523.pdf
26. NV_OPE_User_Manual_Ch2.pdf
... Updated 11/20/2023 (pv10/20/2023) 1. Choose the option that most closely describes the entity you are enrolling. Select the ...
Terms matched: 1  -  Score: 72  -  20 Nov 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_OPE_User_Manual_Ch2.pdf
27. web_announcement_3201_20231030.pdf
... including Fee-For-Service (FFS) recipients and those participating in a Managed Care Organization (MCO) . Prescribers must submit all PA requests to MMA for review and approval ...
Terms matched: 1  -  Score: 38  -  30 Oct 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3201_20231030.pdf
28. web_announcement_3186_20231011.pdf
... EVV system. Essentials to Know: State EVV Sandata Users: If a provider chooses to use the state EVV system through Sandata, they can continue to have ...
Terms matched: 1  -  Score: 37  -  11 Oct 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3186_20231011.pdf
29. web_announcement_3184_20231009.pdf
... 13 and 14, 2023, those who reside in a Managed Care Organization (MCO) coverage area were placed back into their last Managed Care Plan that they ...
Terms matched: 1  -  Score: 55  -  09 Oct 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3184_20231009.pdf
30. web_announcement_Volume 20 Issue 3_20231002.pdf
... claim to the appropriate by HMO Plan Nevada Medicaid HMO/Managed Care Organization (MCO) for processing. Provider may find out which MCO the re- cipient ...
Terms matched: 1  -  Score: 24  -  02 Oct 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2020%20Issue%203_20231002.pdf
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