Nevada Medicaid and Nevada Check Up News (Third 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


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 September 2024 Professional Claims. See Web Announcement 3465.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

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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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.

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... Nevada Medicaid and Nevada Check Up â€" Managed Care Organization(MCO) Change Form If you would like to request a change to your MCO, ...
Terms matched: 1  -  Score: 286  -  12 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO_5006E-S_MCO_Change_Form.pdf
... Nevada Medicaid and Nevada Check Up â€" Managed Care Organization (MCO) Change Form If you would like to request a change to your MCO, ...
Terms matched: 1  -  Score: 286  -  15 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO_5006ES_Nevada_Medicaid_and_Nevada_Check_Up_MCO_Change_Form_1021_Remediated_Fillable_102721.pdf
... the submitter for correction. (When resubmitting a rejected encounter claim, the same MCO ICN/TCN must be used on the corrected encounter claim.) The ...
Terms matched: 1  -  Score: 286  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
... biologic agents, it is reasonable to choose gradual step therapy with 5-ASA. â ... if they would like to change their MCO enrollment. Dr. Capurro informed the ...
Terms matched: 2  -  Score: 285  -  06 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_January_2022.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  01 Feb 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180907.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170901.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  01 Sep 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170724.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180108.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180201.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 280  -  01 Sep 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170314.pdf
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