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]

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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.

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81. web_announcement_2825_20220701.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System will be updated to accept ...
Terms matched: 1  -  Score: 20  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2825_20220701.pdf
82. Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.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: 273  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
83. Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.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: 271  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
84. E-Binder_SSSB_June_2022.pdf
... ; February 2021. • Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate website. https://www.uptodate.com/contents/ ...
Terms matched: 1  -  Score: 11  -  17 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_June_2022.pdf
85. web_announcement_2801_20220609.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System will be updated to accept ...
Terms matched: 1  -  Score: 52  -  09 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2801_20220609.pdf
86. web_announcement_2800_20220609.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System will be updated to accept ...
Terms matched: 1  -  Score: 20  -  09 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2800_20220609.pdf
87. web_announcement_2503_20210517.pdf
... 10, 2021, denied in error with error code 2017 (Recipient enrolled in MCO) . The impacted claims will be automatically reprocessed. A future remittance advice ...
Terms matched: 1  -  Score: 20  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2503_20210517.pdf
88. NV_BillingGuidelines_PT28_20220607.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220607.pdf
89. NV_Pharmacy_Manual.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Pharmacy_Manual.pdf
90. NV_BillingGuidelines_PT28_20220414.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220414.pdf
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