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]

Notifications


Provider Flex is coming soon!
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:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from June 30, 2025 – July 7, 2025. Please refer to Web Announcement 3595 for details.

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

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.

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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... provider, etc.) for billing purposes. In addition, the facility may choose to obtain their own certification for their billing purposes. FA-57 Page 1 of ...
Terms matched: 1  -  Score: 20  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-57.pdf
... . The physician (surgeon) must sign in this space. Section III: Choose A, B, C, or D if patient is already sterile or ...
Terms matched: 1  -  Score: 20  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-50.pdf
... form) . I have the ability and desire to self-direct my care, to choose the ISO provider, to select personal care assistants (PCA), to ...
Terms matched: 1  -  Score: 26  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24C.pdf
... ) Requested number of days per week: Total Units Requested: ICD-10 Code: Choose one: S5102 (Attends 6 or more hours per day) S5100 ( ...
Terms matched: 1  -  Score: 44  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-17.pdf
... number of days per week. d) Indicate the ICD-10 code. e) Choose one of the two HCPCS codes (S5012 or S5100) for the services ...
Terms matched: 1  -  Score: 36  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-17-I.pdf
... . Particular care needs to be taken with such patients in deciding which glucocorticoid to choose, when to initiate treatment, and how best to monitor the child for ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Exondys_51_2017-0314.pdf
... the Nevada Medicaid and Nevada Check Up program as well as Managed Care Organizations (MCO) and Third Party Liability (TPL) . The eligibility request is sent ...
Terms matched: 1  -  Score: 228  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/EVS%20User%20Manual%20Chapter%202%20o072417-n122818%20Modernization.pdf
... Providers, please note: If you choose to have an office administrator register on ... Registering as a Managed Care Organization (MCO) A user registers only once when ...
Terms matched: 2  -  Score: 115  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/EVS%20User%20Manual%20Chapter%201_o092617-n122818%20Modernization.pdf
... assign multiple delegates to perform clinical administration. Providers, please note: If you choose to have an office administrator register on your behalf, the administrator must use ...
Terms matched: 1  -  Score: 82  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/EVS%20Early%20Registration.pdf
... who had a baseline hemoglobin level of 10 to 13 g/dL, not choose to rHuEPO significantly reduced the proportion of patients who received a red- The ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Erythropoiesis-Stimulating%20Agents.pdf
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