Nevada Medicaid and Nevada Check Up News (First 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]

Featured Links

DHCFP EVV

Authorization Criteria

DHCFP Home

EDI Information

PWP User Manual

Provider Flex

Online Provider Enrollment

Provider Login (PWP)

Prior Authorization

Search Fee Schedule

Search Providers

Claims

Trading Partner

Self-Paced Training Videos

Notifications

NOTIFICATION:The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, June 29, 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 coming soon!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Attention Provider Types Not Implemented in Provider Flex:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from June 30, 2025 – July 7, 2025. Please refer to Web Announcement 3595 for details.

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2025 Professional Claims. See Web Announcement 3651.

Top Prior Authorization Denial Reasons for the First Quarter of 2025. See Web Announcement 3630.

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.

Provider Links

DHCFP EVV

Billing Information

Forms

Provider Enrollment

Provider Newsletters

Provider Training

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: choose mco

70 results found containing all search terms. 729 results found containing some search terms.

80 pages of results.
Sort by relevance / Sorted by date ▲
201. web_announcement_368_20101203.pdf
... beginning Jan. 1, 2011, but may start the process immediately if they choose to do so. The re-enrollment requirement does not apply to providers who enrolled ...
Terms matched: 1  -  Score: 23  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_368_20101203.pdf
202. SR-61_20110921.pdf
... NV 89520-3042. To locate form FA-41 on the Magellan Medicaid Administration web site, choose the “Providerâ€drop -down menu, then select the †...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SR-61_20110921.pdf
203. NV_BillingGuidelines_PT56_20111111.pdf
... a recipient is enrolled in a Managed least) 30-day increments and Care Organization (MCO), request prior ï ‚ Provide a weekly summary of the authorization from ...
Terms matched: 1  -  Score: 37  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT56_20111111.pdf
204. NV_BillingGuidelines_PT11_online_062112.pdf
... Service (FFS) When a recipient is enrolled in a Managed Care Organization (MCO), request prior authorization from and submit claims to the MCO. When ...
Terms matched: 1  -  Score: 31  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_062112.pdf
205. NV_BillingGuidelines_PT56_20100623.pdf
... in a Managed per diem rate. General rate information is on Care Organization (MCO), request prior the DHCFP website at http://dhcfp.nv.gov. ...
Terms matched: 1  -  Score: 35  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT56_20100623.pdf
206. Training_FrequentlyAskedQuestions.pdf
... How does EVS notify me that a recipient is in a Managed Care Organization (MCO)? If a recipient is enrolled in an MCO, the detail may ...
Terms matched: 1  -  Score: 150  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Training_FrequentlyAskedQuestions.pdf
207. web_announcement_1022_20151201.pdf
... associated with the National Provider Identifier (NPI) will be displayed and you can choose to revalidate or update. This will take you to the Online Provider Enrollment ...
Terms matched: 1  -  Score: 21  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1022_20151201.pdf
208. NV_BillingGuidelines_PT43_20111205.pdf
... the EPSDT program. Managed care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20111205.pdf
209. Web_Portal_QRG_20120110_Old.pdf
... Administrator (must match step 12 above) . person to register. 14) Choose a Site Key (use left or right arrows to ï ‚ The System ...
Terms matched: 1  -  Score: 61  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Web_Portal_QRG_20120110_Old.pdf
210. web_announcement_413_20110926.pdf
... 19 at the Cashman Center located at 850 Las Vegas Boulevard N. Providers may choose to attend a morning or an afternoon conference in either Reno or Las Vegas ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_413_20110926.pdf
Result Pages: << Previous 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Next >>

Search powered by Zoom Search Engine



Search took 0.058 seconds