Nevada Medicaid and Nevada Check Up News (Third 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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Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2025 Professional Claims. See Web Announcement 3767.

Top Prior Authorization Denial Reasons for the Third Quarter of 2025. See Web Announcement 3758.

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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1. Known_Issues.pdf
... /Update on the “Request Informationâ€panel that they Application with a letter attached Applications cannot proceed to complete their application. indicating that this is a ...
Terms matched: 1  -  Score: 54  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. FA-11E.pdf
... EVS. Request Type: • Initial Prior Authorization: o Check this box if the recipient has not been previously treated by the agency. o For ...
Terms matched: 1  -  Score: 92  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11E.pdf
3. Provider_Enrollment_Information_Booklet.pdf
... requested, the applicant shall provide a letter of justification, and a list of ... rendered and cannot be a post office box, gated community, or virtual address ...
Terms matched: 2  -  Score: 167  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
4. Error_Code_to_EOB_to_ANSI.pdf
... REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the ... Usage: Do not use number/letter. this code for claims attachment( ...
Terms matched: 2  -  Score: 66  -  04 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
5. web_announcement_3753_20251024.pdf
... October 2025, you will get a letter that Managed Care health plans CareSource and ... Medicaid, MCO Changes, P.O. Box 30042, Reno, NV 89520. ...
Terms matched: 2  -  Score: 54  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
6. NV_Flex_User_Guide_Individual.pdf
... Financial Institution. 3. Upload Bank Letter or Voided check. • ... to Add a Specialty.â€A pop-up box will display the available specialties based on ...
Terms matched: 2  -  Score: 65  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
7. NV_Flex_User_Guide_Group.pdf
... Institution. • Upload Bank Letter or Voided check. o Voided checks ... To Add A Specialty.â€A pop-up box will display the available specialties based on ...
Terms matched: 2  -  Score: 56  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Group.pdf
8. Benefit_Enrollment_and_Maintenance_(834).pdf
... to implementation and are identified with a letter “Aâ€in the errata ... For written correspondence: Nevada Medicaid PO Box 30042 Reno, Nevada 89520-3042 5.3 Customer ...
Terms matched: 2  -  Score: 64  -  20 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
9. NV_Billing_General_20250801.pdf
... Nevada Check Up providers will receive a letter notifying them when to revalidate. Providers ... : Nevada Medicaid Dental PA P.O. Box 30042 Reno NV 89520-3042 Personal Care Services ...
Terms matched: 2  -  Score: 142  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
10. NV_Billing_General.pdf
... Nevada Check Up providers will receive a letter notifying them when to revalidate. Providers ... : Nevada Medicaid Dental PA P.O. Box 30042 Reno NV 89520-3042 Personal Care Services ...
Terms matched: 2  -  Score: 142  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
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