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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, November 9, 2025, for scheduled maintenance:
  • Secure Provider Web Portal (PWP), which includes:
    • Recipient Eligibility
    • Provider Claim Appeals
    • Prior Authorization (PA) system
    • Claims Submission
  • Online Provider Enrollment (OPE)
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
  • Trading Partner File Transfer (EDI/SFTP)
  • Business Partner File Transfer (EDI/SFTP)

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 September 2025 Professional Claims. See Web Announcement 3745.

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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Scheduled Site Maintenance

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.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

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Search results for: wa 0852 2611 9277 biaya yang diperlukan untuk memasang interior apartemen tipe 45 apartment depok

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1. Known_Issues.pdf
... €¢ 4871-(Procedure code is not billable on this claim type) 45 Claims, Some Medicare claims are denying • Provider: Please resubmit ...
Terms matched: 1  -  Score: 36  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. Provider_Enrollment_Information_Booklet.pdf
... & Clinic Requirements by Provider Type for Individuals .... 39 Medical Director .... 45 Drug Enforcement Administration (DEA) .... 45 Clinical Laboratories Improvement Act ( ...
Terms matched: 1  -  Score: 114  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
3. Error_Code_to_EOB_to_ANSI.pdf
... Information REF), if present. Updated: 11/04/2025 Page 45 of 185 Claim Error/EOB/ANSI Code Crosswalk ERROR_CODE ERROR_CODE_DESCRIPTION EOB_CODE EOB_CODE_DESCRIPTION ...
Terms matched: 1  -  Score: 77  -  04 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
4. Benefit_Enrollment_and_Maintenance_(834).pdf
... *20200601 DTP*349*D8*20200601 Updated 10/20/2025 45 Nevada Medicaid Electronic Transaction Companion Guide: Benefit Enrollment and Maintenance (834) ...
Terms matched: 1  -  Score: 10  -  20 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
5. NV_Billing_General_20250801.pdf
... From Old MMIS o 44 â€" History Only Converted From Old MMIS o 45 â€" Fee-for-Service Claims Converted From Old MMIS o 46 â€" ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
6. NV_Billing_General.pdf
... From Old MMIS o 44 â€" History Only Converted From Old MMIS o 45 â€" Fee-for-Service Claims Converted From Old MMIS o 46 â€" ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
7. NV_EVS_User_Manual_Ch3.pdf
... fields. Click Add Insurance to add the Other Insurance Details to the claim. 45 Updating Other Insurance Details Select the sequence number of any other insurance line item ...
Terms matched: 1  -  Score: 33  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
8. NV_EVS_User_Manual_Ch4.pdf
... • Effective date 44 The example below is sorted by Provider Specialty: 45 Additional Resources Using the Provider Web Portal YouTube Videos: Prior Authorization (PA ...
Terms matched: 1  -  Score: 12  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
9. NV_EVS_User_Manual_Ch1.pdf
... you to respond to any correspondences or inquiries you send through the secured portal. 45 9. Read the user agreement and select the User Agreement box. By ...
Terms matched: 1  -  Score: 12  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
10. NV_BillingGuidelines_PT12_online_20250804.pdf
... provider type 81 will be denied. Please see the Billing Guide for provider types 45 and 81 for billing instructions. Smoking/Tobacco Cessation Counseling Current Procedural Terminology ...
Terms matched: 1  -  Score: 20  -  27 Aug 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT12_online_20250804.pdf
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