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 March 2024 Professional Claims. See Web Announcement 3335.

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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... 2020 32 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  09 Sep 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20220523.pdf
... 2022 32 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  09 Sep 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20220824.pdf
... submitted in writing. You may submit comments in one of two ways (please choose only one of the ways listed below): Electronically: You may email ...
Terms matched: 1  -  Score: 23  -  17 Aug 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2874_20220817.pdf
... in Nevada WebIZ, unless the patient chooses to opt-out of inclusion in the system ... €" Medicaid Fee-For-Service • MCO â€" Managed Care Organization â ...
Terms matched: 2  -  Score: 44  -  16 Aug 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/COVID-19_Community-Based_Testing_Billing_Guide.pdf
... Portal. Managed Care claims will be accepted by the applicable Managed Care Organization (MCO) and may be submitted on paper or electronically. Providers should access EVS ...
Terms matched: 1  -  Score: 35  -  16 Aug 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/COVID-19_Dental_Billing_Guide.pdf
... claim to the appropriate Covered by HMO Nevada Medicaid HMO/Managed Care Organization (MCO) Plan for processing. Provider may find out which MCO the recipient belongs ...
Terms matched: 1  -  Score: 36  -  15 Aug 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2871_20220815.pdf
... acknowledge in writing that they understand their right to select a qualified provider of their choosing; and 7. Only qualified providers provide prescribed services within scope of their ...
Terms matched: 1  -  Score: 20  -  28 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT14_Spec300.pdf
... acknowledge in writing that they understand their right to select a qualified provider of their choosing; and 7. Only qualified providers provide prescribed services within scope of their ...
Terms matched: 1  -  Score: 20  -  28 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT82_Spec300.pdf
... the enrollees to have sufficient time to choose an MCO and return their letter to ... Nevada Check Up Managed Care Organization (MCO) 2022 Open Enrollment Managed Care Organization ...
Terms matched: 2  -  Score: 154  -  06 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2834_20220706.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System has been updated to accept ...
Terms matched: 1  -  Score: 52  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2826_20220701.pdf
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