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]

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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:
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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.

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421. Binder_DUR_2018_1018.pdf
... unfortunately similar to what the other ones are. After seeing their recommendations from the MCO as saying that they would just like to keep this criteria. Chapter 1200 ...
Terms matched: 1  -  Score: 59  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2018_1018.pdf
422. Botulinum Toxins.pdf
... of Lower bladder retraining or habit retraining) . Urinary Tract • When choosing a behavioral management program, take into account Dysfunction that prompted voiding and habit ...
Terms matched: 1  -  Score: 10  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Botulinum%20Toxins.pdf
423. Binder_DUR_2018_0726.pdf
... what the choices between which agent to choose. There is no preference for the ... is when Medicaid recipient transfers from one MCO to another? Jim Marx: Right ...
Terms matched: 2  -  Score: 128  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2018_0726.pdf
424. Binder_DUR_2018_0426.pdf
... reads, the director sell point one member recommended by each Managed Care Organization or MCO contracted with the DHCFP. This member shall not be an employee or contractor ...
Terms matched: 1  -  Score: 130  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2018_0426.pdf
425. Binder_DUR_2018_0124.pdf
... Jeffery: Duane brought up a good point. Because we have to incorporate the MCO data with this too. We didn't give them an opportunity to opine on ...
Terms matched: 1  -  Score: 48  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2018_0124.pdf
426. Binder_DUR_2017_04.pdf
... of just the recipient. Mary Griffith: Typically it is the recipient because they choose which pharmacy to change to. As long as the recipient is aware that ...
Terms matched: 1  -  Score: 29  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017_04.pdf
427. Binder_DUR_2017_01.pdf
... Opioid Treatment Program. In addition, DATA reduced the regulatory burden on physicians who choose to practice opioid addiction therapy by permitting qualified physicians to apply for and receive ...
Terms matched: 1  -  Score: 11  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017_01.pdf
428. Binder_DUR_2017-1011.pdf
... such patients in deciding which glucocorticoid to choose, when to initiate treatment, and ... ™s has been conducted. The MCO expansion was effective July 1, 2017 ...
Terms matched: 2  -  Score: 39  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017-1011.pdf
429. Binder_DUR_2017-0824.pdf
... the drug utilization review board. As a reminder for the audience, if you choose to speak, please limit remarks to 5 minutes. We will give plenty ...
Terms matched: 1  -  Score: 14  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017-0824.pdf
430. Binder_DUR_2016_07.pdf
... . James Marx: There was an announcement that all recipients are being moved to MCO, is that true? Mary Griffith: No, I don’ ...
Terms matched: 1  -  Score: 14  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2016_07.pdf
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