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 ▲
331. E-Binder_PT_June_2019.pdf
... combining all of them together would be more confusing and would then lead to not choosing the simplest which would be the oral form or if they advocate that it ...
Terms matched: 1  -  Score: 65  -  16 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_June_2019.pdf
332. web_announcement_735_20140519.pdf
... of managed care. They will either be enrolled in a Managed Care Organization (MCO) because their household or case members are enrolled in it, because they ...
Terms matched: 1  -  Score: 155  -  29 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_735_20140519.pdf
333. NV_Medicaid_News_2017-0113.pdf
... Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipi- 2 2017 HCPCS Code Update ents. You will also ...
Terms matched: 1  -  Score: 90  -  29 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Medicaid_News_2017-0113.pdf
334. NV_Medicaid_News_2016-0930.pdf
... series of breakout sessions. Providers can choose from Medicaid the following breakout sessions when ... both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. ï ‚ You ...
Terms matched: 2  -  Score: 39  -  29 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Medicaid_News_2016-0930.pdf
335. NV Medicaid News 2013-0108.pdf
... ) . The EP may (DHCFP) launched the Nevada EHR program on August choose either path as part of the Medicaid Program. 6, 2012, and ...
Terms matched: 1  -  Score: 25  -  29 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV%20Medicaid%20News%202013-0108.pdf
336. web_announcement_550_20130103.pdf
... to make the re- enrollment process smoother for the provider. Providers may also choose from the following in January: ï ‚ New providers with Medicaid can call ...
Terms matched: 1  -  Score: 23  -  29 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_550_20130103.pdf
337. PCS_Provider_Training_(2019_Version)_2019-0603.pdf
... to verify identity. • Choose whether log in is on a personal ... Eligibility Changes from Managed Care Organization (MCO) to Fee-for-Service (FFS) â ...
Terms matched: 2  -  Score: 120  -  03 Jun 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PCS_Provider_Training_(2019_Version)_2019-0603.pdf
338. PT_13_Psychiatric_Hospital_Inpatient_Training_2019.pdf
... in their answer to 4 the Challenge Question to verify identity. 5 4. Choose whether log in is on a personal computer or public computer. 5. ...
Terms matched: 1  -  Score: 56  -  12 Jun 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_13_Psychiatric_Hospital_Inpatient_Training_2019.pdf
339. Binder_DUR_2019-0725.pdf
... Growth Hormone Managed Care Organization name: Choose an item. Please place a check ... we have similar limits to every other MCO and fee for service as well as ...
Terms matched: 2  -  Score: 151  -  18 Jun 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2019-0725.pdf
340. NV_BillingGuidelines_PT29_online_20190405.pdf
... by Managed Care Organizations (MCOs) . If a recipient is enrolled in an MCO, you must bill the MCO directly. If the recipient is enrolled in ...
Terms matched: 1  -  Score: 35  -  01 Jul 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20190405.pdf
Result Pages: << Previous 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 Next >>

Search powered by Zoom Search Engine



Search took 0.053 seconds