Nevada Medicaid and Nevada Check Up News (First Quarter 2025 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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For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Attention Provider Types Not Implemented in Provider Flex:
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Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2025 Professional Claims. See Web Announcement 3651.

Top Prior Authorization Denial Reasons for the First Quarter of 2025. See Web Announcement 3630.

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.

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71. Binder_DUR_2017-1011.pdf
... such patients in deciding which glucocorticoid to choose, when to initiate treatment, and ... ™s has been conducted. The MCO expansion was effective July 1, 2017 ...
Terms matched: 2  -  Score: 303  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017-1011.pdf
72. NV_Billing_General_online_2010-05-28_to_2010-06-14.pdf
... 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_2010-05-28_to_2010-06-14.pdf
73. web_announcement_Volume 17, Issue 1_20200416.pdf
... some of the published web announcements: Choose Service Location Web Announcement 2137: Pharmacy ... Organization and Resolutions and/or (MCO) websites. The Providers section includes ...
Terms matched: 2  -  Score: 299  -  16 Apr 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2017,%20Issue%201_20200416.pdf
74. 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
75. 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
76. FFS_DUR_Binder_Oct_2020.pdf
... ) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod ... CMS. The Fee-for- Service and MCO Surveys will be presented at the next ...
Terms matched: 2  -  Score: 295  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Oct_2020.pdf
77. NV_Billing_General_Modernization.pdf
... Prior Authorization requirements • New TPL contractor contact information • New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 292  -  17 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_Modernization.pdf
78. companionguide837D_hipaa.pdf
... is up to the trading partner to choose which client software they will use. ... 19/2015 Removed all references for MCO encounter claims. Added information for Health ...
Terms matched: 2  -  Score: 287  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837D_hipaa.pdf
79. newsletter_v8i3.pdf
... . Reminder - Federal Payment Providers may choose to attend a morning or an afternoon ... males is a covered service under an MCO plan, but is not covered under ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v8i3.pdf
80. newsletter_v2i3.pdf
... visit http://dhcfp.state.nv.us and choose “Public Noticesâ€from the ... to as a Managed Care Organization (MCO), are: ™ Log ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v2i3.pdf
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