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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Notifications

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, November 23, 2025, for scheduled maintenance:
  • Secure Provider Web Portal (PWP), which includes:
    • Recipient Eligibility
    • Provider Claim Appeals
    • Prior Authorization (PA) system
    • Claims Submission
  • 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)

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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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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1. Known_Issues.pdf
... /or Change/Update Change/Update on the “Request Informationâ€panel that they Application with a letter attached Applications cannot proceed to complete their application ...
Terms matched: 1  -  Score: 12  -  14 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. NV_Flex_User_Guide_Group.pdf
... €œGo to Sectionâ€button or select the section from the Table of Contents panel to navigate back to that page. 1.10.1. Error Identification Once on the ...
Terms matched: 1  -  Score: 12  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Group.pdf
3. NV_Flex_User_Guide_Individual.pdf
... œGo To Sectionâ€button or select the section from the “Sectionsâ€panel to navigate back to that page. 1.9.1. Error Identification Once on the ...
Terms matched: 1  -  Score: 12  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
4. NV_Billing_General_20250801.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. Updated 08/01/2025 Billing Manual Pv02/20/2025 ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
5. NV_Billing_General.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. Updated 10/17/2025 Billing Manual Pv08/01/2025 ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
6. NV_EVS_User_Manual_Ch3.pdf
... primary, check this box; When this box is checked the Other Insurance Information panel will appear on the Submit Dental Claim: Step 2 • Total ...
Terms matched: 1  -  Score: 316  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
7. NV_EVS_User_Manual_Ch4.pdf
... required fields. 4 When the Create Authorization is first displayed, all of the panels are expanded. Collapse: Click on the (â €" ) button ...
Terms matched: 1  -  Score: 97  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
8. NV_EVS_User_Manual_Ch7.pdf
... 2. Enter www.medicaid.nv.gov in the address bar. 3. From the Featured Links panel on the left-hand side of the home page, click Search Providers. To ...
Terms matched: 1  -  Score: 21  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch7.pdf
9. NV_EVS_User_Manual_Ch8.pdf
... attachments using the PWP: • Upload the attachment using the File Exchange panel in the PWP. It is recommended that the attachment should be uploaded prior ...
Terms matched: 1  -  Score: 20  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch8.pdf
10. NV_BillingGuidelines_PT43.pdf
... a provider performs all of the constituent procedures of a covered organ or disease oriented panel, the provider must submit a claim for the panel rather than for each ...
Terms matched: 1  -  Score: 80  -  04 Aug 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
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