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]

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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 January 2025 Professional Claims. See Web Announcement 3559.

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.

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31. NV_BillingGuidelines_PT11.pdf
... Service (FFS) When a recipient is enrolled in a Managed Care Organization (MCO), request prior authorization from and submit claims to the MCO. When ...
Terms matched: 1  -  Score: 31  -  18 Nov 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
32. NV_BillingGuidelines_PT11_online_031424.pdf
... Service (FFS) When a recipient is enrolled in a Managed Care Organization (MCO), request prior authorization from and submit claims to the MCO. When ...
Terms matched: 1  -  Score: 31  -  18 Nov 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_031424.pdf
33. web_announcement_3465_20241021.pdf
... claim to the appropriate by HMO Plan Nevada Medicaid HMO/Managed Care Organization (MCO) for processing. Client eligibility can be verified within the EVS by reviewing ...
Terms matched: 1  -  Score: 20  -  21 Oct 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3465_20241021.pdf
34. NV_Billing_General_20240313.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  -  18 Oct 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20240313.pdf
35. NV_OPE_User_Manual_Ch2.pdf
... select the type of ownership from the drop-down list. Business Information: 1. Choose the option that most closely describes the entity you are enrolling. Select the ...
Terms matched: 1  -  Score: 83  -  15 Oct 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_OPE_User_Manual_Ch2.pdf
36. web_announcement_3456_20241009.pdf
... starting October 1, 2024, to choose a new health plan. Recipients go ... Nevada Check Up Managed Care Organization (MCO) 2024 Open Enrollment Managed Care Organization ...
Terms matched: 2  -  Score: 179  -  09 Oct 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3456_20241009.pdf
37. Immunomodulators_2015-0930.pdf
... should have the option to start treatment again. Remission maintenance  For patients that choose maintenance therapy, offer azathioprine or mercaptopurine as monotherapy to maintain remission when previously ...
Terms matched: 1  -  Score: 29  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0930.pdf
38. Immunomodulators_2015-0812.pdf
... should have the option to start treatment again. Remission maintenance  For patients that choose maintenance therapy, offer azathioprine or mercaptopurine as monotherapy to maintain remission when previously ...
Terms matched: 1  -  Score: 29  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0812.pdf
39. Immunomodulators_2014-0918.pdf
... the option to start treatment again. Remission maintenance • For patients that choose maintenance therapy, offer azathioprine or mercaptopurine as monotherapy to maintain remission when previously ...
Terms matched: 1  -  Score: 29  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2014-0918.pdf
40. Immunomodulators_2013-1218.pdf
... the option to start treatment again. Remission maintenance • For patients that choose maintenance therapy, offer azathioprine or mercaptopurine as monotherapy to maintain remission when previously ...
Terms matched: 1  -  Score: 29  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2013-1218.pdf
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