Nevada Medicaid and Nevada Check Up News (First 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]

Notifications

Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.

Unwinding COVID-19 Information

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 April 2024 Professional Claims. See Web Announcement 3361.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See Web Announcement 3280.

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.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

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... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_06-15.pdf
... by the Division of Health Care Financing and Policy (DHCFP) Benefits, and MCO or 10 business days prior to the date of the requested training. If ...
Terms matched: 1  -  Score: 38  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Medicaid_News_2015-0710.pdf
... of two acceptable methods of contraception unless the patient has had a tubal sterilization or chooses to use a Copper T 380A IUD or LNg 20 IUS, in which ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Pulmonary_Arterial_Hypertension_Agents_2014-0213.pdf
... (Chapple et al )of micturitions 1.47; P>0.05) . patients choosing to vs remain on the lower Secondary: Secondary: treatment dose Change in ...
Terms matched: 1  -  Score: 22  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Urinary%20Antispasmodics_2015-1002.pdf
... of two acceptable methods of contraception unless the patient has had a tubal sterilization or chooses to use a Copper T 380A IUD or LNg 20 IUS, in which ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Pulmonary%20Arterial%20Hypertension%20Agents.pdf
... Change in the At week four, both solifenacin and tolterodine LA therapies resulted in choosing to number of urgency comparable reductions in the number of urgency episodes from baseline ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Urinary%20Antispasmodics.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Anticoagulants_092212.pdf
... be When a recipient is enrolled in a Managed documented in the Care Organization (MCO), request PA recipient's medical from and submit claims to the MCO. ...
Terms matched: 1  -  Score: 36  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT12_20111111.pdf
... in a Managed number of LOA days for the billing period. Care Organization (MCO) upon admission, that MCO is responsible for the first 45 days of ...
Terms matched: 1  -  Score: 35  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT19_20100607.pdf
... ‚ Electronic Data Interchange (EDI) and Allscripts-PayerPath ï ‚ Managed Care Organization (MCO) and Fee For Service (FFS) Magellan Medicaid Administration 2011 Provider Training ...
Terms matched: 1  -  Score: 21  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Training_Catalog_2011.pdf
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