Nevada Medicaid and Nevada Check Up News (Second 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

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, September 22, 2024, for scheduled maintenance:
  • Secure Provider Web Portal (Electronic Verification System – EVS), which includes:
    • Recipient Eligibility
    • Provider Claim Appeals
    • Prior Authorization (PA) system
    • Claims Submission
  • Online Provider Enrollment (OPE)
  • Gabby®, which includes:
    • Customer Service Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider PASRR
  • Trading Partner File Transfer (EDI/SFTP)
  • Business Partner File Transfer (EDI/SFTP)

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 July 2024 Professional Claims. See Web Announcement 3398.

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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... Pharmaceuticals; December 2017. ï ‚ Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate Web site. www.uptodate.com. Updated November 2, 2017 ...
Terms matched: 1  -  Score: 21  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2018-11.pdf
... Pharmaceuticals; December 2017. ï ‚ Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate Web site. www.uptodate.com. Updated November 2, 2017 ...
Terms matched: 1  -  Score: 21  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2018-1212.pdf
... .; July 2016. x Simon G. Unipolar major depression in adults: Choosing initial treatment. UpToDate Web site. www.uptodate.com. Updated December 23, 2015 ...
Terms matched: 1  -  Score: 12  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antidepressants_Other_2017-09.pdf
... Choice of agents generally depends upon the relative emetogenic potential of the regimen. When choosing among a class of agents, guidelines have suggested that all 5-HT3 receptor antagonists ...
Terms matched: 1  -  Score: 10  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antiemetics_(5-HT3_Antagonist_and_Combinations)_02-10-15.pdf
... 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  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical%20(Second-Generation)%20Antipsychotics.pdf
... 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  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical%20(Second-Generation)%20Antipsychotics_07232012.pdf
... Daily files will be generated if DHCFP has updates for a recipient enrolled in an MCO. If no updates are performed, then no enrollment file will be generated ...
Terms matched: 1  -  Score: 46  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834)_-_Mod.pdf
... Daily files will be generated if DHCFP has updates for a recipient enrolled in an MCO. If no updates are performed, then no enrollment file will be generated ...
Terms matched: 1  -  Score: 43  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintanance_(834)_n062818.pdf
... Authorization Forms, continued †' While on the Forms page, locate and choose appropriate forms †' Make sure that you follow the instructions on each ...
Terms matched: 1  -  Score: 26  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Behavioral_Health_Training_041618.pdf
... of the level of urine albumin excretion. Â In adult kidney transplant recipients, choose a blood pressure -lowering agent after taking into account the time after transplantation, ...
Terms matched: 1  -  Score: 21  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Beta-adrenergic_antagonists_2015-0812.pdf
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