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]

Featured Links

Nevada Medicaid EVV

Authorization Criteria

Nevada Medicaid Home

EDI Information

PWP User Manual

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 4 p.m. Pacific Time on Sunday, October 11, 2026, through 3 a.m. Pacific Time on Monday, October 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)

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 August 2026 Professional Claims. See Web Announcement 4009.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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.

Provider Links

Nevada Medicaid 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

78 results found containing all search terms. 753 results found containing some search terms.

84 pages of results.
Sort by relevance / Sorted by date ▼
21. NV_BillingGuidelines_PT85_Spec320.pdf
... duplication of services, the HHP will contact ManagedCare@nvha.nv.gov to verify that the MCO is not already providing these services to the recipient. Health Home for beneficiaries ...
Terms matched: 1  -  Score: 68  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_Spec320.pdf
22. Nevada Medicaid FAQS.pdf
... Members/BLU/MCOMain/ If you are in a Managed Care Plan (MCO) â€" Please call your plan at: Anthem Blue Cross and ...
Terms matched: 1  -  Score: 61  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Nevada%20Medicaid%20FAQS.pdf
23. web_announcement_3815_20260109.pdf
... member's coverage should call the member's health plan (CareSource or SilverSummit) first. MCO health plans are responsible for ensuring continuity of care for members, including during ...
Terms matched: 1  -  Score: 115  -  30 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3815_20260109.pdf
24. NV_BillingGuidelines_PT17_Specialty_188_20231206.pdf
... to pay CCBHCs providing services under a contract with a Medicaid Managed Care Organization (MCO; also known as a Managed Care Entity [MCE]) additional payments ...
Terms matched: 1  -  Score: 23  -  23 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_188_20231206.pdf
25. NV_BillingGuidelines_PT17_Spec188.pdf
... to pay CCBHCs providing services under a contract with a Medicaid Managed Care Organization (MCO; also known as a Managed Care Entity [MCE]) additional payments ...
Terms matched: 1  -  Score: 23  -  23 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec188.pdf
26. NV_Billing_General_20251215.pdf
... 2025 30 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
27. NV_Billing_General_20251017.pdf
... 2025 30 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 195  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
28. New_Provider_Road_Map.pdf
... PWP) Series courses for you to choose from to gain Provider Web Portal valuable ... Medical Non-Citizens, Managed Care Organization (MCO), and Pregnancy (PREG) ...
Terms matched: 2  -  Score: 39  -  21 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/New_Provider_Road_Map.pdf
29. NV_BillingGuidelines_PT43_20250804.pdf
... 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: 47  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20250804.pdf
30. web_announcement_3753_20251024.pdf
... are the differences that can help you choose a health plan that meets your needs ... in the mail to NV Medicaid, MCO Changes, P.O. Box 30042, ...
Terms matched: 2  -  Score: 35  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
Result Pages: << Previous 1 2 3 4 5 6 7 8 9 10 11 12 13 Next >>

Search powered by Zoom Search Engine



Search took 0.056 seconds