Nevada Medicaid and Nevada Check Up News (Second Quarter 2017 Provider Newsletter) (Updated August 4, 2017) [Read]

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

Authorization Criteria

DHCFP Home

EDI Enrollment Forms and Information

EVS User Manual

Online Provider Enrollment

Provider Login (EVS)

Prior Authorization

Search Fee Schedule

Search Providers

Notifications

The Division of Health Care Financing and Policy (DHCFP) has selected LIBERTY Dental Plan of Nevada (LIBERTY) as the new Managed Care Dental Benefits Administrator (DBA) effective January 1, 2018, to serve recipients enrolled in a Managed Care Organization (MCO).[See Web Announcement 1442]

The Nevada Medicaid Provider Web Portal (PWP) Upgrade has been implemented. With this upgrade, Dental/Orthodontia, Adult Day Health Care (ADHC) and Personal Care Services (PCS) providers can generate a prior authorization request via the Provider Web Portal.[See Web Announcement 1415]

The Nevada Provider Web Portal update resulted in a complete change in the website and its associated webpages. Users of the secure Provider Web Portal are advised to remove all previously bookmarked pages and clear any previous activity in your browser to assist with accessing the system. You can clear previous activity in most browsers by navigating to your menu item for internet or browser options and deleting cookies, temporary internet files, and web form information.

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

Reminder of Requirements Regarding Ordering, Prescribing or Referring Provider on Claims. See Web Announcement 1372

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

Provider Links

Billing Information

E-Prescribing

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

Sunday
8:00PM - 12:30AM

Provider Enrollment Checklists

To see which documents must be submitted with your Provider Enrollment Packet, click the name of your provider type(s) in the list below. If your provider type is not in the list below, please contact the Provider Enrollment Unit at (877) 638-3472 for requirements.

Note: Out of state providers must also submit proof of Medicaid eligibility in the state that services are/were rendered.

Provider Type Title Updated Date
10 Outpatient Surgery, Hospital Based 04/20/16
11 Hospital, Inpatient 02/18/16
12 Hospital, Outpatient 02/18/16
13 Psychiatric Hospital, Inpatient 04/20/16
14 Behavioral Health Outpatient Treatment n/a
16 Intermediate Care Facilities for Individuals with Intellectual Disabilities, Public 04/20/16
17 Special Clinics n/a
19 Nursing Facility 04/20/16
20 Physician, M.D., Osteopath, D.O. 08/25/17
21 Podiatrist 08/25/17
22 Dentist 01/03/13
23 Hearing Aid Dispenser & Related Supplies 08/25/17
24 Advanced Practice Registered Nurse 08/30/17
25 Optometrist 08/25/17
26 Psychologist 07/19/16
27 Radiology and Non-invasive Diagnostic Centers 12/01/14
28 Pharmacy 04/28/17
29 Home Health Agency 07/05/17
30 Personal Care Services - Provider Agency 10/04/16
32 Ambulance, Air or Ground 10/25/16
33 Durable Medical Equipment, Prosthetics, Orthotics and Disposable Medical Supplies (DMEPOS) 07/05/17
34 Therapy n/a
36 Chiropractor 08/30/17
38 Home & Community Based Waiver – Individuals with Intellectual Disabilities and Related Conditions n/a
39 Adult Day Health Center 03/10/15
41 Optician, Optical Business, Ocularist 12/07/12
43 Laboratory, Pathology Clinical 08/30/17
44 Swing-bed, Acute Hospital 04/20/16
45 End Stage Renal Disease (ESRD) Facility 08/30/17
46 Ambulatory Surgical Centers, Freestanding 08/30/17
47 Indian Health Programs and Tribal Clinics 12/17/12
48 Home and Community Based Services Waiver for the Frail Elderly n/a
51 Indian Health Service Hospital, Inpatient (Tribal) 04/24/15
52 Indian Health Service Hospital, Outpatient (Tribal) 08/30/17
54 Targeted Case Management 03/03/16
55 Transitional Rehabilitative Center, Outpatient 11/30/12
56 Inpatient Rehabilitation and Long Term Acute Care (LTAC) Specialty Hospitals 02/19/16
57 Home and Community Based Services Waiver for the Elderly in Adult Residential Care 12/29/16
58 Waiver for Persons with Physical Disabilities (“PD”) n/a
59 Home and Community Based Services Waiver for the Elderly – Augmented Personal Care Services 12/29/16
60 School Based 08/30/17
63 Residential Treatment Center (RTC) 08/13/14
64 Hospice 04/20/16
65 Hospice, Long Term Care 04/20/16
68 Intermediate Care Facilities for Individuals with Intellectual Disabilities, Private 04/20/16
72 Nurse Anesthetist 08/30/17
74 Nurse Midwife 08/30/17
75 Critical Access Hospital (CAH), Inpatient 02/18/16
76 Audiologist n/a
77 Physician's Assistant 08/30/17
78 Indian Health Service Hospital, Inpatient (Non-Tribal) 08/30/17
79 Indian Health Service Hospital, Outpatient (Non-Tribal) 08/30/17
81 Hospital Based End Stage Renal Disease (ESRD) Provider 10/02/15
82 Behavioral Health Rehabilitative Treatment n/a
83 Personal Care Services - Intermediary Service Organization 10/04/16
85 Applied Behavior Analysis (ABA) n/a

If you have any questions, please contact the Provider Enrollment Unit at (877) 638-3472 from 8:00AM to 5:00PM, Monday through Friday.