Nevada Medicaid and Nevada Check Up News (Second 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]

Notifications


Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2025 Professional Claims. See Web Announcement 3651.

Top Prior Authorization Denial Reasons for the First Quarter of 2025. See Web Announcement 3630.

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.

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Monday
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... – ª Self directed providers disabilities) $175 billion â – ª Providers that choose to accept funds must attest to the terms and conditions in payments to be ...
Terms matched: 1  -  Score: 41  -  14 Aug 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Relief_Fund_Step-by-Step_Provider_Guide.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 66  -  17 Aug 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_Sept_2020.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 23  -  03 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2020-09.pdf
... Presentation Presented to NV DUR Board on October 22, 2020 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 63  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_Oct_2020.pdf
... Drug Use Review Board Meeting OCTOBER 22, 2020 2020 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 60  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_Oct_2020.pdf
... - 24 Standard DUR Reports - 26 Topical Antipruritics Clinical Presentation DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 60  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_Oct_2020.pdf
... ) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod ... CMS. The Fee-for- Service and MCO Surveys will be presented at the next ...
Terms matched: 2  -  Score: 31  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Oct_2020.pdf
... , program oversight of managed care partners when applicable, and statewide (FFS and MCO) initiatives. The Drug Use Review Board (DUR) is a requirement ...
Terms matched: 1  -  Score: 12  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Survey_FFY2019.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 23  -  26 Oct 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2020-12.pdf
... ; November 2017. • Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate website. www.uptodate.com. Updated November 9, 2019. ...
Terms matched: 1  -  Score: 10  -  26 Oct 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2020-12.pdf
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