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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431. PT_13_Psychiatric_Hospital_Inpatient_Training_2020.pdf
... in their answer to 4 the Challenge Question to verify identity. 5 4. Choose whether log in is on a personal computer or public computer. 5. ...
Terms matched: 1  -  Score: 63  -  30 Dec 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_13_Psychiatric_Hospital_Inpatient_Training_2020.pdf
432. PT_63_RTC_Training_2020.pdf
... denied or fewer days. If you choose to request fewer days than were originally ... member of a Managed Care Organization (MCO) . - The QIO-like vendor will ...
Terms matched: 2  -  Score: 79  -  04 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_63_RTC_Training_2020.pdf
433. SilverSummit_DUR_Binder_Jan_2021.pdf
... DUR Reports  23 Anticonvulsants, Misc. 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: 76  -  04 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_Jan_2021.pdf
434. Health_Plan_of_Nevada_DUR_Binder_Jan_2021.pdf
... Drug Use Review Board Meeting JANUARY 28, 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: 60  -  04 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_Jan_2021.pdf
435. FFS_DUR_Binder_Jan_2021.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: 11  -  05 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Jan_2021.pdf
436. Trading%20Partners%20Fully%20Certified%20Report.pdf
... Home Companion X X ANGEL’S TOUCH HOME CARE LLC X Anthem (MCO) X X Apex EDI X X X Availity, LLC X X X ...
Terms matched: 1  -  Score: 96  -  06 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading%2520Partners%2520Fully%2520Certified%2520Report.pdf
437. Anthem_DUR_Binder_Jan_2021.pdf
... Presentation Presented to NV DUR Board on January 28, 2021 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 57  -  06 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_Jan_2021.pdf
438. Hospice_Provider_Training_2021.pdf
... “Formsâ€page, locate the “Hospice Formsâ€section and choose appropriate forms. †' Make sure that all instructions are followed. ...
Terms matched: 1  -  Score: 88  -  19 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hospice_Provider_Training_2021.pdf
439. COVID_Flyers.pdf
... public for in-person services** If you are in a Managed Care Plan (MCO) â€" Please call your plan at: Anthem Blue Cross and ...
Terms matched: 1  -  Score: 83  -  03 Feb 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/COVID_Flyers.pdf
440. Multiple_Sclerosis_Agents_2021-04.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  -  05 Mar 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2021-04.pdf
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