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.

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491. web_announcement_Volume 18 Issue 4_20211230.pdf
... Up News Volume 18, Issue 4 New Managed Care Organization Fourth Quarter 2021 (MCO) Contract and Caseload Inside Redistribution Effective January 1, 2022 This Issue: ...
Terms matched: 1  -  Score: 296  -  30 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2018%20Issue%204_20211230.pdf
492. web_announcement_Volume_2018_20Issue_204_20211230.pdf
... Up News Volume 18, Issue 4 New Managed Care Organization Fourth Quarter 2021 (MCO) Contract and Caseload Inside Redistribution Effective January 1, 2022 This Issue: ...
Terms matched: 1  -  Score: 296  -  03 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume_2018_20Issue_204_20211230.pdf
493. NV_BillingGuidelines_PT28_20211228.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  04 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20211228.pdf
494. Anthem_DUR_Binder_January_2022.pdf
... Presentation Presented to NV DUR Board on January 27, 2022 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 115  -  06 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_January_2022.pdf
495. SilverSummit_DUR_Binder_January_2022.pdf
... DUR Reports â€" 41 CGRP Antagonists 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: 115  -  06 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_January_2022.pdf
496. FFS_DUR_Survey_FFY2020.pdf
... presented many challenges to State's in terms of drug coverage, meetings, and ___ MCO(s ) (Insert program monitoring. Nevada 3 the number Medicaid of ...
Terms matched: 1  -  Score: 88  -  06 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Survey_FFY2020.pdf
497. FFS_DUR_Binder_January_2022.pdf
... biologic agents, it is reasonable to choose gradual step therapy with 5-ASA. â ... if they would like to change their MCO enrollment. Dr. Capurro informed the ...
Terms matched: 2  -  Score: 21  -  06 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_January_2022.pdf
498. Health_Plan_of_Nevada_DUR_Binder_January_2022.pdf
... Drug Use Review Board Meeting JANUARY 27, 2022 2022 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 113  -  11 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_January_2022.pdf
499. NMO_5006E-S_MCO_Change_Form.pdf
... Nevada Medicaid and Nevada Check Up â€" Managed Care Organization(MCO) Change Form If you would like to request a change to your MCO, ...
Terms matched: 1  -  Score: 286  -  12 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO_5006E-S_MCO_Change_Form.pdf
500. web_announcement_2655_20211215.pdf
... Announcement 2655 Attention All Providers: Recipients May Request to Change Managed Care Organization (MCO) Plans In December, Medicaid recipients who are members of Managed Care Organizations ...
Terms matched: 1  -  Score: 186  -  20 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2655_20211215.pdf
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