Nevada Medicaid and Nevada Check Up News (First 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]

Notifications

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • 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)
  • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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.

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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... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 26  -  07 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11.pdf
... without using the copy System.NullReferenceException: Object functionality, until a resolution is reference not set to an instance of an object in place. 10 Web Portal, The ...
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... PLEASE CONTACT THE occurrence has been reached. made for same/similar procedure within set CARE COORDINATOR time frame. 3353 SPECIALIZED FOSTER CARE CHECKLIST 3352 ELIGIBILITY CHECKLIST NOT ...
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... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Hospitals are not permitted to submit a claim ...
Terms matched: 1  -  Score: 44  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Hospitals are not permitted to submit a claim ...
Terms matched: 1  -  Score: 44  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
... provided. If the insurer denies the claim as a non-covered service or a non-covered setting, then documentation of the denial may be submitted with the claim to Medicaid ...
Terms matched: 1  -  Score: 182  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
... provided. If the insurer denies the claim as a non-covered service or a non-covered setting, then documentation of the denial may be submitted with the claim to Medicaid ...
Terms matched: 1  -  Score: 182  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
... in the following locations: 1. In an office location. - Is this setting a gated community? Yes No ____ Office Address - (No P.O ...
Terms matched: 1  -  Score: 53  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT14_Flex.pdf
... the retroactive time. Please note that this does not extend the timely filing policy set forth in Medicaid Services Manual Chapter 100 Medicaid Program. The list of claims ...
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... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Special billing instructions All hospice claims are to ...
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