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]

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 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.

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. 752 results found containing some search terms.

83 pages of results.
Sort by relevance / Sorted by date ▲
481. NV_BillingGuidelines_PT32_Spec_932.pdf
... the webpage. Prior authorization Emergency transportation services for Fee-for-service and Managed Care Organization (MCO) recipients do not require prior authorization. Payment is contingent upon eligibility, ...
Terms matched: 1  -  Score: 109  -  07 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_932.pdf
482. NV_BillingGuidelines_PT32_Spec_932_online_20200430.pdf
... the webpage. Prior authorization Emergency transportation services for Fee-for-service and Managed Care Organization (MCO) recipients do not require prior authorization. Payment is contingent upon eligibility, ...
Terms matched: 1  -  Score: 108  -  07 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_932_online_20200430.pdf
483. NV_BillingGuidelines_PT28_20211206.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  14 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20211206.pdf
484. NV_BillingGuidelines_PT28_20211214.pdf
... . 15 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  14 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20211214.pdf
485. NMO_5006ES_Nevada_Medicaid_and_Nevada_Check_Up_MCO_Change_Form_1021_Remediated_Fillable_102721.pdf
... Nevada Medicaid and Nevada Check Up â€" Managed Care Organization (MCO) Change Form If you would like to request a change to your MCO, ...
Terms matched: 1  -  Score: 286  -  15 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NMO_5006ES_Nevada_Medicaid_and_Nevada_Check_Up_MCO_Change_Form_1021_Remediated_Fillable_102721.pdf
486. MCO_FAQs_Recipients_101521_Fully_Remediated.pdf
... a managed care health plan, you choose a doctor to be your primary care ... Recipient General and Managed Care Organization (MCO) FAQ’s Updated 10 ...
Terms matched: 2  -  Score: 275  -  15 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/MCO_FAQs_Recipients_101521_Fully_Remediated.pdf
487. web_announcement_2658_20211217.pdf
... 2658 Attention All Providers: Recipient/Enrollee Webpage Created with Managed Care Organization (MCO) Expansion Information Effective immediately, a new webpage has been created on the ...
Terms matched: 1  -  Score: 58  -  17 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2658_20211217.pdf
488. NV_BillingGuidelines_PT17_Specialty_188_20191022.pdf
... recipients regardless if they are under FFS Medicaid or a Medicaid Managed Care Organization (MCO) . Use Direct Data Entry (DDE) to submit claims to Nevada ...
Terms matched: 1  -  Score: 21  -  23 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_188_20191022.pdf
489. web_announcement_Volume 18 Issue 4_20211230.pdf
... Up News Volume 18, Issue 4 New Managed Care Organization Fourth Quarter 2021 (MCO) Contract and Caseload Inside Redistribution Effective January 1, 2022 This Issue: ...
Terms matched: 1  -  Score: 296  -  30 Dec 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2018%20Issue%204_20211230.pdf
490. web_announcement_Volume_2018_20Issue_204_20211230.pdf
... Up News Volume 18, Issue 4 New Managed Care Organization Fourth Quarter 2021 (MCO) Contract and Caseload Inside Redistribution Effective January 1, 2022 This Issue: ...
Terms matched: 1  -  Score: 296  -  03 Jan 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume_2018_20Issue_204_20211230.pdf
Result Pages: << Previous 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Next >>

Search powered by Zoom Search Engine



Search took 0.066 seconds