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]

Notifications


Multi-Factor Authentication Frequently Asked Questions

Unwinding COVID-19 Information

Known System Issues-Click HERE

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 December 2024 Professional Claims. See Web Announcement 3538.

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.

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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... DAA experience patients and retreatment. I’m not here to advocate for choosing one agent over another. All the DAA single tablet regimens have established high ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_March_2018.pdf
... Carl Jeffery: You can certainly make Orencia preferred. We did our best to choose what we thought would work well. Nikki Beck: I would make a ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_March_2017.pdf
... DAA experience patients and retreatment. I’m not here to advocate for choosing one agent over another. All the DAA single tablet regimens have established high ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_June_2018.pdf
... have 5 minutes per entity, so choose who you are going to have speak ... TPL format to more align with the MCO structure that can reduce some of the ...
Terms matched: 2  -  Score: 98  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_March_2015.pdf
... Nevada Medicaid Durable Medical Equipment Provider Training 51 Delegate Assignment, continued †' Choose the Functions you want the delegate to be able to perform †' ...
Terms matched: 1  -  Score: 25  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/DME_PT33_Provider_Training_042618.pdf
... now select role-based functions that a delegate is authorized to access. †' Choose the Functions you want the delegate to be able to Provider Web Portal 5.0 ...
Terms matched: 1  -  Score: 39  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Dental_and_Orthodontia_PWP_Training_120117.pdf
... Protocol (SFTP) client software and it is up to the trading partner to choose which client software they will use. Nevada Medicaid does not provide or recommend ...
Terms matched: 1  -  Score: 14  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837P_hipaa.pdf
... Nevada Medicaid and Nevada Check Up Professional Health Care Claims and Managed Care Organization (MCO) Encounters Nevada Medicaid Management Information System (NV MMIS) State of Nevada ...
Terms matched: 1  -  Score: 223  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837P.pdf
... 6. Instruction tables .... 6-1 6.1. 005010X222A1 Professional health care claims and MCO encounter claims (837P) .... 6-1 7. Payer specific business rules ...
Terms matched: 1  -  Score: 137  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837P_hipaa-01-12.pdf
... is up to the trading partner to choose which client software they will use. ... Medicare or this loop for each other MCO payer. Omit Nevada Medicaid coverage information ...
Terms matched: 2  -  Score: 23  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837I_hipaa.pdf
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