Nevada Medicaid and Nevada Check Up News (Second Quarter 2026 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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IMPORTANT: Nevada Medicaid is conducting a swift revalidation effort on high risk providers. If selected, you will receive a revalidation notice with instructions through the standard communication process. See Web Announcement 3935 for more information.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2026 Professional Claims. See Web Announcement 4031.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 4053.

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 https://NevadaMedicaid.nv.gov/ and the Billing Guide for your provider type at www.medicaid.nv.gov.

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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.

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1. Error_Code_to_EOB_to_ANSI.pdf
... , if present. 273 TYPE OF BILL MISSING 4100 ... /10/2026 Page 45 of 162 Claim Error ... /10/2026 Page 98 of 162 Claim Error ...
Terms matched: 3  -  Score: 463  -  12 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. How_to_Create_PA_Tip_Sheet.pdf
... Authorization - Create Authorization â€" Select Medical or Dental and then select Process Type from the drop-down menu. - Requesting Provider Information â€" Populated with ...
Terms matched: 1  -  Score: 55  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/How_to_Create_PA_Tip_Sheet.pdf
3. Quick_Tip_Guide_Inpatient_Med_Surg.pdf
... continued stay update process (Edit button will not appear on portal): Auth Types • Dental, Dental Orthodontia • Retrospective review †...
Terms matched: 1  -  Score: 37  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Inpatient_Med_Surg.pdf
4. Quick_Tip_Guide_Inpatient_Psychiatric_PRTF.pdf
... and appropriate: • Illegible handwritten notes will not be reviewed. Please type the notes. • If there is information that needs to be ...
Terms matched: 1  -  Score: 23  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Inpatient_Psychiatric_PRTF.pdf
5. Quick_Tip_Guide_Outpatient_Med_Surg.pdf
... the documentation is legible, including the physician’s handwritten notes. Please type the notes if necessary. • Include a contact person and telephone ...
Terms matched: 1  -  Score: 20  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Outpatient_Med_Surg.pdf
6. Nursing_Facility_Tracking_Form_Validation_Guide_2016-0615.pdf
... . The service level requested does not match the NF form is submitted with a type of LOC that LOC for this member. does not match the Service Level ...
Terms matched: 1  -  Score: 20  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Nursing_Facility_Tracking_Form_Validation_Guide_2016-0615.pdf
7. NV_EVS_User_Manual_Ch9.pdf
... will only return a history of paid claims for K0815 for the recipient. Code Type: For Medical searches, use the Code Type drop-down list to select if ...
Terms matched: 1  -  Score: 121  -  28 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch9.pdf
8. PASRR_LOC_NF_Training_2021.pdf
... LOC / NF Training 12 Types of PASRRs Types of ... / LOC / NF Training 45 PASRR Page 3, ... / LOC / NF Training 98 Form Completion Form Completion ...
Terms matched: 3  -  Score: 264  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
9. PASRR_PWP_QRG.pdf
... to the "Add New Association" section. (User Name) 4) Type your Organization Name in the "Enter Organization Nameâ€textbox. 5) ...
Terms matched: 1  -  Score: 23  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_PWP_QRG.pdf
10. Institutional_Claim_Part_B_Tip_Sheet.pdf
... to submit an Institutional claim with Medicare Part B coverage. Step 1: Select type of claim being submitted (Institutional) . Step 2: Select the Claim ...
Terms matched: 1  -  Score: 97  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Institutional_Claim_Part_B_Tip_Sheet.pdf
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