Nevada Medicaid and Nevada Check Up News (Fourth 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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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 January 2025 Professional Claims. See Web Announcement 3559.

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

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2024. See Web Announcement 3458.

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. NV_Medicaid_News_2012-0719.pdf
... listed below. register, you will choose from the following Breakout Sessions. Note ... to the Annual Medi- Organizations (MCO) SEPTEMBER: The September workshops will ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Medicaid_News_2012-0719.pdf
82. companionguide837I_hipaa.pdf
... is up to the trading partner to choose which client software they will use. ... Medicare or this loop for each other MCO payer. Omit Nevada Medicaid coverage information ...
Terms matched: 2  -  Score: 287  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837I_hipaa.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: 286  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
84. 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  -  12 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO_5006E-S_MCO_Change_Form.pdf
85. NMO_5006ES_Nevada_Medicaid_and_Nevada_Check_Up_MCO_Change_Form_1021_Remediated_Fillable_102721.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
86. FFS_DUR_Binder_January_2022.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
87. 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: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180201.pdf
88. 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  -  01 Sep 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170724.pdf
89. 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  -  01 Feb 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180907.pdf
90. 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  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170901.pdf
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