Nevada Medicaid and Nevada Check Up News (First Quarter 2018 Provider Newsletter) [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]

Notifications

Urgent: The adjudication of claims for physician-administered drugs submitted last week may be delayed due to a claims processing issue. The claims may pend with edit code 0899 (National Drug Code (NDC) claims are pending during transition period) on remittance advices dated June 22, 2018. This notification will be updated when the issue is resolved and when the claims are processed.

Attention Electronic Billing Trading Partners: Preparations Continue for the Medicaid Management Information System Modernization Project – Inbound Companion Guides Now Available. [See Web Announcement 1617]

Attention All Providers and Electronic Billing Trading Partners: Medicaid Management Information System Enhancements Will Improve Claims and Enrollment Processes. [See Web Announcement 1559]

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]

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

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
15 Registered Dietitian 12/15/17
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 10/25/17
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.