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]

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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 July 2026 Professional Claims. See Web Announcement 3983.

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.

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81. 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: 299  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
82. 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
83. 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
84. FFS_DUR_Binder_Oct_2020.pdf
... ) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod ... CMS. The Fee-for- Service and MCO Surveys will be presented at the next ...
Terms matched: 2  -  Score: 295  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Oct_2020.pdf
85. NV_Billing_General_Modernization.pdf
... Prior Authorization requirements • New TPL contractor contact information • New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 292  -  17 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_Modernization.pdf
86. newsletter_v8i3.pdf
... . Reminder - Federal Payment Providers may choose to attend a morning or an afternoon ... males is a covered service under an MCO plan, but is not covered under ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v8i3.pdf
87. companionguide837D_hipaa.pdf
... is up to the trading partner to choose which client software they will use. ... 19/2015 Removed all references for MCO encounter claims. Added information for Health ...
Terms matched: 2  -  Score: 287  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837D_hipaa.pdf
88. newsletter_v2i3.pdf
... visit http://dhcfp.state.nv.us and choose “Public Noticesâ€from the ... to as a Managed Care Organization (MCO), are: ™ Log ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/newsletter_v2i3.pdf
89. companionguide837I_hipaa.pdf
... is up to the trading partner to choose which client software they will use. ... Medicare or this loop for each other MCO payer. Omit Nevada Medicaid coverage information ...
Terms matched: 2  -  Score: 287  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/companionguide837I_hipaa.pdf
90. NV_Medicaid_News_2012-0719.pdf
... listed below. register, you will choose from the following Breakout Sessions. Note ... to the Annual Medi- Organizations (MCO) SEPTEMBER: The September workshops will ...
Terms matched: 2  -  Score: 287  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Medicaid_News_2012-0719.pdf
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