Nevada Medicaid and Nevada Check Up News (Fourth 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]

Notifications

NOTIFICATION: Some Provider Flex services will be temporarily unavailable due to scheduled maintenance from 7 p.m. Pacific Time on Friday, March 6, 2026, to 11 a.m. Pacific Time on Saturday, March 7, 2026.

During this time:
  • New enrollment applications cannot be started.
  • Revalidation and Update applications will remain available; and
  • Previously started applications can still be accessed and resumed.

URGENT NOTIFICATION: Update regarding the Electronic Visit Verification (EVV) claims processing error. Nevada Medicaid did not receive some claims from Sandata (Optum) in time for the February 06, 2026 financial cycle. The issue was resolved this week. EVV providers can contact Sandata Technologies at (833) 545-0394 or support@sandata.com for assistance.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for January 2026 Professional Claims. See Web Announcement 3840.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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.

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

Enhance your search:
  • Note that you can use "*" and "?" as wildcards.

  • Enclosing more than one word in double quotes ("search engine") will search for the exact phrase.
Example Zoom search template page

Search this site

Enter one or more keywords to search for using the Zoom Search Engine.
Note that '*' and '?' wildcards are supported.



Match:

Search results for: wa 0859 3970 0884 anggaran dana pasang pintu kaca frame tasikmadu karanganyar

No results found containing all search terms. 814 results found containing some search terms.

82 pages of results.
... 20/2019 7/29/2019 8/9 /2019 Professional (Frames, purchases), V2107-(Spherocylinder, • Once resolved ...
Terms matched: 1  -  Score: 11  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
... set Types: M - Professional Audit is set to post at CARE COORDINATOR time frame. the detail: Claim Regions 21, 23 and 59 will suspend All ...
Terms matched: 1  -  Score: 355  -  10 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
... on your enrollment application, you are required to notify Nevada Medicaid within the time frame established in MSM Chapter 100, Section 103.3(A ) . Changes or ...
Terms matched: 1  -  Score: 36  -  24 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT93_Spec704.pdf
... revisions; added prior authorization appeals mailing address 07/01/2015 Retroeligibility time frame changed from five days to ten days; 22 and 23 updated instructions under ...
Terms matched: 1  -  Score: 99  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... revisions; added prior authorization appeals mailing address 07/01/2015 Retroeligibility time frame changed from five days to ten days; 22 and 23 updated instructions under ...
Terms matched: 1  -  Score: 99  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
... revisions; added prior authorization appeals mailing address 07/01/2015 Retroeligibility time frame changed from five days to ten days; 22 and 23 updated instructions under ...
Terms matched: 1  -  Score: 99  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
... field analyzer full threshold programs 30-2, 24-2, or 30/60-2) V2020 Frames, purchases. • Encounter = 1 unit • Limit ...
Terms matched: 1  -  Score: 10  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2024-0828.pdf
... field analyzer full threshold programs 30-2, 24-2, or 30/60-2) V2020 Frames, purchases. • Encounter = 1 unit • Limit ...
Terms matched: 1  -  Score: 10  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
... SECTION VIII. TREATMENT PLAN Provide goals, interventions, expected outcomes, and time frames. SECTION IX. SIGNIFICANT LIFE EVENTS AND FAMILY HISTORY Provide significant life events ...
Terms matched: 1  -  Score: 20  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11B.pdf
... Chapter 100 and the Billing Manual for information concerning the claim appeal process and time frames. ...
Terms matched: 1  -  Score: 20  -  10 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3760_20251110.pdf
Result Pages: 1 2 3 4 5 6 7 8 9 10 11 Next >>

Search powered by Zoom Search Engine



Search took 0.076 seconds