Nevada Medicaid and Nevada Check Up News (First 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]

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NOTIFICATION: Known Issue with Resubmitting Returned to Provider (RTP) Applications
This issue has been resolved, and the impacted applications have been placed in the appropriate status for review.

Provider Flex is coming soon!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Attention Provider Types 24, 72, 74, and 77:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from April 14, 2025 – April 21, 2025. Please refer to Web Announcement 3595 for details.

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Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2025 Professional Claims. See Web Announcement 3593.

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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491. newsletter_v7i3.pdf
... verify that the break-out session conference, which will address recipient eligibility, prior you choose has your provider type indicated next to it. authorization, clinical claim editor ...
Terms matched: 1  -  Score: 27  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v7i3.pdf
492. newsletter_v4i3.pdf
... for “Rendering/Servicing Provider IDâ€please Health Services, providers will choose enter NPI for “Billing Provider.â€a Delegated Administrator who will CMS-1500 ...
Terms matched: 1  -  Score: 27  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v4i3.pdf
493. 5-HT1 Receptor Agonists_2015-1002.pdf
... (P value not reported) . When permitted to years of age with attacks choose between eletriptan and sumatriptan SC for subsequent treatment, 78% of vs migraine ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/5-HT1%20Receptor%20Agonists_2015-1002.pdf
494. NV_BillingGuidelines_PT63_20100916.pdf
... Guide A Residential Treatment Center (RTC) is a A Managed Care Organization (MCO) provides all mental health facility having 17 beds or medical care (e.g ...
Terms matched: 1  -  Score: 26  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT63_20100916.pdf
495. PT_39_ADHC_Training_061518.pdf
... Medicaid Adult Day Health Care Provider Training 36 Delegate Assignment, continued †' Choose the Functions you want the delegate to be able to perform †' ...
Terms matched: 1  -  Score: 26  -  25 Jun 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_39_ADHC_Training_061518.pdf
496. 2013_Care_Management.pdf
... 6386 VLBW 179 189 184 169 Rate 2.34% 2.48% 2.73% 2.65% MCO Live Births 6671 7955 8963 8363 VLBW 70 86 110 100 Rate 1.05% ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/2013_Care_Management.pdf
497. Behavioral_Health_Training_041618.pdf
... Authorization Forms, continued †' While on the Forms page, locate and choose appropriate forms †' Make sure that you follow the instructions on each ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Behavioral_Health_Training_041618.pdf
498. Therapy_Provider_Training_041818.pdf
... œSubmitâ€Nevada Medicaid Therapy Provider Training 35 Delegate Assignment, continued †' Choose the Functions you want the delegate to be able to perform †' ...
Terms matched: 1  -  Score: 26  -  18 Apr 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Therapy_Provider_Training_041818.pdf
499. Selective_Serotonin_(5-HT1)_Agonists_2013-0812.pdf
... (P value not reported) . When permitted to years of age with attacks choose between eletriptan and sumatriptan SC for subsequent treatment, 78% of vs migraine ...
Terms matched: 1  -  Score: 26  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Selective_Serotonin_(5-HT1)_Agonists_2013-0812.pdf
500. Selective Serotonin 5HT1 Agonists 2014 11.pdf
... (P value not reported) . When permitted to years of age with attacks choose between eletriptan and sumatriptan SC for subsequent treatment, 78% of vs migraine ...
Terms matched: 1  -  Score: 26  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Selective%20Serotonin%205HT1%20Agonists%202014%2011.pdf
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