Attention Nursing Facility and ICF/IID Provider Types 19 and 68: Tracking Process Is Changing on July 1, 2016 [Web Announcement 1141]

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]

Nevada Medicaid and Nevada Check Up News (First Quarter 2017 Provider Newsletter) [Read]


Attention All Nevada Medicaid Providers: Managed Care Organization (MCO) Changes Effective 2017. See Web Announcement 1380

PCS, Prior Authorization and Web Portal Upgrade Frequently Asked Questions (FAQs) [Review]

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

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.

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

8:00PM - 12:30AM

General Information

Customer Service Center
Claim inquiries and general information
Mailing Address:
Customer Service
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472

Nevada Medicaid Central Office
State policy inquiries and Fair Hearing requests
Mailing Address:
1100 East William St.
Suite 102
Carson City, NV 89701
Phone: (877) 638-3472 and (775) 684-3600

Medicaid Recipient Customer Service
Las Vegas District Office: (702) 668-4200
Reno District Office: (775) 687-1900
All other areas: (866) 569-1746

Automated Response System (ARS)
Recipient eligibility, recent payments, claim status, and prior authorization information via phone
Phone: (800) 942-6511

Electronic Verification System (EVS)
Recipient eligibility, claim status, prior authorization status, provider payments

Note: For EVS, there can only be one provider administrator for each NPI/FEIN/zip code. The provider administrator must register as a “Provider” and will be responsible for creating delegates for that provider. If you do not know who is the provider administrator is in your office, call the Customer Service Center at (877) 638-3472.

Mailing Address

Mail claims (CMS-1500, UB and ADA), claim appeals, and other written correspondence to:

Hewlett Packard Enterprise
P.O. Box 30042
Reno, NV 89520-3042

For claim appeals, write "Attn: Claim Appeals" on the envelope. For claim inquiries and all other written correspondence, write "Attn: Customer Service" on the envelope.

Web Sites

Nevada Medicaid Web Site
Web announcements, billing manual, billing guidelines, forms, pharmacy information

DHCFP Web Site
Medicaid Services Manual, rates, policy updates, public notices

Provider Training

Mailing Address:
Provider Training
P.O. Box 30042
Reno NV 89520-3042

Electronic Billing

Mailing Address:
EDI Coordinator
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Electronic Billing")
Fax: (775) 335-8502

Managed Care Organizations (MCOs)

The Nevada Medicaid and Nevada Check Up contracted Managed Care Organizations (MCOs) are AMERIGROUP Community Care and Health Plan of Nevada.

AMERIGROUP Community Care
Provider Contracting – Fran Ettinger
Phone: (702) 228-1308, ext. 59757

Provider Inquiry Line
(for eligibility, claims and pre-certification)
Phone: (800) 454-3730

Phone: (800) 454-3730
Fax: (800) 964-3627

Provider Self-Service Website

Claims Address
AMERIGROUP Community Care
Attn: Nevada Claims
P.O. Box 61010
Virginia Beach, VA 23466-1010

Amerigroup Nevada Member Services
Phone: (800) 600-4441

Health Plan of Nevada (HPN)
Provider Contracting
(800) 745-7065

Member Services
Phone: (800) 962-8074
Fax: (702) 240-6281

Claims Address
Health Plan of Nevada
P.O. Box 15645
Las Vegas, NV 89114

Provider Enrollment

Mailing Address:
Provider Enrollment
PO Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Provider Enrollment")
Fax: (775) 335-8593

Prior Authorization

Prior Authorization
Phone: (800) 525-2395
Fax: (866) 480-9903

Prior Authorization for Dental and Personal Care Aide

Mailing Address:
"Dental PA" or "PCA PA"
P.O. Box 30042
Reno, NV 89520-3042
Phone: (800) 525-2395
Dental Fax: (855) 709-6848
PCA Fax: (855) 709-6846

Prior Authorization for All Other Service Types (except Pharmacy)
Phone: (800) 525-2395
Fax: (866) 480-9903

Mail prior authorization appeals to:
Hewlett Packard Enterprise
Nevada Prior Authorization - Appeals
6511 SE Forbes Ave., Bldg. 283
P.O. Box 19287
Topeka, KS 66619-0287


Customer Service Center
Pharmacy prior authorization requests
Phone: (855) 455-3311
Fax: (855) 455-3303

Technical Call Center
General pharmacy inquiries
Phone: (866) 244-8554

Pharmacy Web PA
Submit prior authorization requests online for prescription drugs. Select "Pharmacy Web PA Login" from the "Pharmacy" menu on this web site. This will take you to the EVS Login. After login, prescribers will see a link for Pharmacy PA.

Public Hearings

Providers are welcome to attend public hearings and voice their opinion on policy changes. Call the number below to receive electronic or written notices of scheduled public hearings.

Phone: (775) 684-3681


Phone: (800) 525-2395
Fax: (855) 709-6847

Third Party Liability (TPL) Identification and Recovery

If you believe a recipient's private insurance records are incorrect, please contact Health Management Systems, Inc. (HMS) at:

Mailing Address:
HMS - NV Third Party Liability
P.O. Box 12610
Reno, NV 89510

Phone: (775) 335-1040
Toll Free: (855) 528-2596
Fax: (972) 284-5959

If you believe a recipient's Medicare record is incorrect, please contact the DHCFP at:

Electronic Health Records (EHR) Incentive Program

Customer Service Center
CGI Business Services
Phone: (888) 639-3452