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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... Sample Medicaid Card.... 14 Fee For Service vs. Managed Care .... 14 MCO Contact Information .... 15 Chapter 4: Prior and Retrospective Authorization .... ...
Terms matched: 1  -  Score: 303  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_online_2009-08-26_to_2010-03-17.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%20arterial%20hypertension%202014%2011.pdf
... a rate of 2.4/100 patient-years (P =0.68) . acetate could choose calcium carbonate. There were 78 deaths due to other causes in the sevelamer ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Phosphorus_Depleters_06-15.pdf
... other payments segment that must be used for each scenario method. The payer must choose the appropriate scenario method with the segment chart, 10 Document version: 3.0 ...
Terms matched: 1  -  Score: 12  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SR-92_20111111.pdf
... P <0.020) . The placebo placebo capsules group showed no color preference, choosing the red capsule 51% of opportunities chosen, and and the blue capsule ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Sedative%20Hypnotics.pdf
... a rate of 2.4/100 patient-years (P =0.68) . acetate could choose calcium carbonate. There were 78 deaths due to other causes in the sevelamer ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Phosphorus%20depleters%202014%2011.pdf
... warnings, drug interactions, past response to treatment, and comorbid medical conditions when choosing a medication for treatment. • Most patients do not experience a ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Selective%20Serotonin%20reupdate%20inhb%202014%2011.pdf
... ), Thrombolytic antithrombotic therapy is not recommended. For patients who Therapy 9th Edition choose antithrombotic therapy, aspirin (75 to 325 mg daily) is (2012 ...
Terms matched: 1  -  Score: 46  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Platelet%20Inhibitors.pdf
... . In either case, co-prescribe with a proton pump inhibitor (PPI), choosing the one with the lowest acquisition cost. Â All oral NSAIDs/COX-2 ...
Terms matched: 1  -  Score: 21  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Nonsteroidal%20Anti-Inflammatory%20Drugs%20(NSAIDs).pdf
... of discontinuation symptoms than other SSRIs. o Take into account toxicity in overdose when choosing an antidepressant for people at significant risk for suicide. Be aware that compared ...
Terms matched: 1  -  Score: 11  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Serotonin_Modulators_2014-0213.pdf
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