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. Error_Code_to_EOB_to_ANSI.pdf
... Crosswalk ERROR_CODE ERROR_CODE_DESCRIPTION EOB_CODE EOB_CODE_DESCRIPTION REASON_CODE REASON_CODE_DESCRIPTION REMARK_CODE REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the maximum 16 Claim/service lacks information ...
Terms matched: 1  -  Score: 28  -  04 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_Billing_General.pdf
... the home icon in the top left corner of the screen. Website The Menu Bar across the top of the website has drop-down menu selections for Providers, PWP ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. NV_Billing_General_20250801.pdf
... the home icon in the top left corner of the screen. Website The Menu Bar across the top of the website has drop-down menu selections for Providers, PWP ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
4. NV_EVS_User_Manual_Ch1.pdf
... frame of the website contains a menu of tabs for main website content. Menu Bar The Menu Bar across the top of the website has drop-down menu selections for ...
Terms matched: 1  -  Score: 56  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
5. NV_EVS_User_Manual_Ch7.pdf
... web browser such as Chrome or Firefox. 2. Enter www.medicaid.nv.gov in the address bar. 3. From the Featured Links panel on the left-hand side of the ...
Terms matched: 1  -  Score: 53  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch7.pdf
6. NV_EVS_User_Manual_Ch4.pdf
... displays. Selection of an individual recipient from either tab displays the Member In Focus bar at the top of the page, and summary information below, including their ...
Terms matched: 1  -  Score: 42  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
7. NV_EVS_User_Manual_Ch6.pdf
... browser such as Internet Explorer or Firefox. 2. Enter www.medicaid.nv.gov in the address bar. 3. The Nevada Medicaid Provider website opens as shown below. Then ...
Terms matched: 1  -  Score: 38  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch6.pdf
8. NV_EVS_User_Manual_Ch8.pdf
... browser such as Internet Explorer or Firefox. 2. Enter www.medicaid.nv.gov in the address bar. 3. The Nevada Medicaid Provider website opens as shown below. Click ...
Terms matched: 1  -  Score: 21  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch8.pdf
9. NV_EVS_User_Manual_Ch2.pdf
... displays. Selection of an individual member from either tab displays the Member In Focus bar at the top of the page, and summary information below, including their ...
Terms matched: 1  -  Score: 20  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch2.pdf
10. NV_EVS_User_Manual_Ch3.pdf
... displays. Selection of an individual member from either tab displays the Member In Focus bar at the top of the page and summary information below, including their recent ...
Terms matched: 1  -  Score: 12  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
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