Nevada Medicaid and Nevada Check Up News (First Quarter 2025 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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2025 Professional Claims. See Web Announcement 3651.

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341. SilverSummit_DUR_Binder_July_2021.pdf
... â€" 16 Antimigraine Medications - Miscellaneous Clinical Presentations 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 35  -  15 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_July_2021.pdf
342. Anthem_DUR_Binder_July_2021.pdf
... Presentation Presented to NV DUR Board on July 22, 2021 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 35  -  15 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_July_2021.pdf
343. Health_Plan_of_Nevada_DUR_Binder_July_2021.pdf
... Drug Use Review Board Meeting JULY 22, 2021 2021 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 31  -  15 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_July_2021.pdf
344. E-Binder_SSSB_June_2021.pdf
... 2021. • Stovall J. Bipolar mania and hypomania in adults: choosing pharmacotherapy. UpToDate website. www.uptodate.com/ . Updated April 11, 2021. ...
Terms matched: 1  -  Score: 10  -  09 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_June_2021.pdf
345. Quick_Tip_Guide_Inpatient_Psychiatric_and_RTC.pdf
... denied first at the acute level of care. • Should the provider choose to not appeal they may request these dates of service at a lower level ...
Terms matched: 1  -  Score: 20  -  07 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Inpatient_Psychiatric_and_RTC.pdf
346. NV_BillingGuidelines_PT28_20210331.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  -  01 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20210331.pdf
347. NV_BillingGuidelines_PT28_20210526.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  -  01 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20210526.pdf
348. NV_BillingGuidelines_PT29_online_20191125.pdf
... by Managed Care Organizations (MCOs) . If a recipient is enrolled in an MCO, you must bill the MCO directly. If the recipient is enrolled in ...
Terms matched: 1  -  Score: 36  -  01 Jun 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20191125.pdf
349. Antipsychotics_Atypical_2021-06.pdf
... 2021. • Stovall J. Bipolar mania and hypomania in adults: choosing pharmacotherapy. UpToDate website. www.uptodate.com/ . Updated April 11, 2021. ...
Terms matched: 1  -  Score: 10  -  06 May 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antipsychotics_Atypical_2021-06.pdf
350. NMO-3430A_Instructions.pdf
... agency as listed below. 5. Any person who fills out the form must choose only one event, not multiple events. The description of the event can ...
Terms matched: 1  -  Score: 14  -  06 May 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO-3430A_Instructions.pdf
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