Nevada Medicaid and Nevada Check Up News (Fourth 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


Multi-Factor Authentication Frequently Asked Questions

Unwinding COVID-19 Information

Known System Issues-Click HERE

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 December 2024 Professional Claims. See Web Announcement 3538.

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

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2024. See Web Announcement 3458.

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; November 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: 22  -  19 Feb 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_March_2020.pdf
... March 3, 2020 Web Announcement 2119 Prior Authorization System Updated to Allow Providers to Choose Service Location Effective March 3, 2020, the online prior authorization system has ...
Terms matched: 1  -  Score: 23  -  03 Mar 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2119_20200303.pdf
... FFS recipients and does NOT apply to recipients enrolled in a Managed Care Organization (MCO) (Health Plan of Nevada, Anthem Blue Cross and Blue Shield Healthcare ...
Terms matched: 1  -  Score: 23  -  03 Mar 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2120_20200303.pdf
... €¢ FFS only â€" does not apply to recipients enrolled in an MCO • Preferred Diabetic Products: Omnipod, Dexcom G6 and FreeStyle Libre ...
Terms matched: 1  -  Score: 16  -  27 Mar 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Diabetic_Supply_Webinar_Presentation.pdf
... Utilization 36 Standard Reports 41 Anti-Migraine Medications CGRP's 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: 113  -  06 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_April_2020.pdf
... Presentation Presented to NV DUR Board on April 30, 2020 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 83  -  06 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_April_2020.pdf
... People- It's Who We Are And What We Do 13 Managed Care Organizations (MCO) Thomas Beranek â€" Silver Summit Health Plan Ryan Bitton †...
Terms matched: 1  -  Score: 14  -  08 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_2020-04_v2.pdf
... 2019 34 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: 198  -  13 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20191121.pdf
... some of the published web announcements: Choose Service Location Web Announcement 2137: Pharmacy ... Organization and Resolutions and/or (MCO) websites. The Providers section includes ...
Terms matched: 2  -  Score: 35  -  16 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2017,%20Issue%201_20200416.pdf
... PT) 32 ambulance providers, were carved out of the Managed Care Organization (MCO) contracts and are now billed as Fee-for-Service Medicaid. Some GEMT claims for ...
Terms matched: 1  -  Score: 42  -  06 May 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2187_20200506.pdf
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