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 (Second Quarter 2017 Provider Newsletter) [Read]

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

Notifications

In preparation for the Nevada Provider Web Portal upgrade, the online Prior Authorization system will be unavailable from 5:00 p.m. PDT on July 21, 2017, through 8:00 a.m. PDT on July 24, 2017. The Provider Web Portal will be available beginning at 8:00 a.m. PDT on July 24, 2017. Pharmacy PAs can continue to be submitted via fax (855-455-3303) or phone (855-455-3311) through OptumRx.

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]

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

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
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 02/17/11
21 Podiatrist 02/17/11
22 Dentist 01/03/13
23 Hearing Aid Dispenser & Related Supplies 06/03/10
24 Certified R.N. Practitioner 02/17/11
25 Optometrist 06/03/10
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 06/14/10
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 04/26/11
44 Swing-bed, Acute Hospital 04/20/16
45 End Stage Renal Disease (ESRD) Facility 06/14/10
46 Ambulatory Surgical Centers, Freestanding 06/14/10
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) 06/30/10
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 06/30/10
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 02/17/11
74 Nurse Midwife 02/17/11
75 Critical Access Hospital (CAH), Inpatient 02/18/16
76 Audiologist n/a
77 Physician's Assistant 06/30/10
78 Indian Health Service Hospital, Inpatient (Non-Tribal) 06/30/10
79 Indian Health Service Hospital, Outpatient (Non-Tribal) 06/30/10
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.