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 (Third Quarter 2016 Provider Newsletter) [Read]

Notifications

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

Sunday
8:00PM - 12:30AM

Electronic billing (also called Electronic Data Interchange or "EDI") speeds payment and eliminates costs associated with paper claims. You can submit electronic claims through a clearinghouse or through your existing, HIPAA-compliant business management software.


If you have any questions, please contact our EDI Coordinator at:
Telephone: (877) 638-3472
Fax: (775) 335-8502

EDI Enrollment Forms

EDI enrollment forms are for completion and submission by active or enrolling Nevada Medicaid and Nevada Check Up providers only.

Form Number Title
FA-35 Electronic Transaction Agreement for Service Centers
FA-36 Service Center Operational Information
FA-37 Service Center Authorization
FA-39 Payerpath Enrollment
EDI Announcements
Title Date
Payerpath Claim Submission Training for February 2017 Jan. 20, 2017
Payerpath Claim Submission Training for January 2017 Dec. 28, 2016
Payerpath Claim Submission Training for December 2016 Nov. 21, 2016
Payerpath Claim Submission Training for November 2016 Oct. 24, 2016
Payerpath Claim Submission Training for October 2016 Sept. 29, 2016
Payerpath Claim Submission Training for September 2016 Sept. 1, 2016
Payerpath Claim Submission Training for August 2016 July 19, 2016
Payerpath Claim Submission Training for July 2016 June 24, 2016
Payerpath Claim Submission Training for June 2016 May 26, 2016
Payerpath Claim Submission Training for May 2016 April 21, 2016
Payerpath Claim Submission Training for April 2016 March 25, 2016
Electronic 837I Inpatient Claims with ICD-10 Codes Are Processing Appropriately Feb. 23, 2016
Payerpath Claim Submission Training for March 2016 Feb. 18, 2016
Payerpath Claim Submission Training for February 2016 Jan. 21, 2016
Claim Adjustment Reason Code for Presumptive Payment Adjustment on 837 Electronic Transactions Dec. 21, 2015
Payerpath Claim Submission Training for January 2016 Dec. 17, 2015
Payerpath Claim Submission Training for December 2015 Nov. 20, 2015
Payerpath Claim Submission Training for November 2015 Oct. 21, 2015
Payerpath Claim Submission Training for October 2015 Sept. 28, 2015
It’s 1 month until ICD-10 Codes Must Be Used on Claims with Dates of Service on or after October 1, 2015. Have You Tested to Ensure Claims will be Accepted and Processed? Sept. 1, 2015
Payerpath Claim Submission Training for September 2015 Aug. 19, 2015
Payerpath Claim Submission Training for August 2015 July 20, 2015
ICD-10 Testing Encouraged before Implementation Date July 1, 2015
Payerpath Claim Submission Training for July 2015 June 18, 2015
ICD-10 Testing and Facts Information June 11, 2015
Payerpath Claim Submission Training for June 2015 May 19, 2015
Payerpath Claim Submission Training for May 2015 April 23, 2015
Payerpath Claim Submission Training for April 2015 March 20, 2015
Payerpath Claim Submission Training for March 2015 Feb. 23, 2015
Payerpath Claim Submission Training for February 2015 Jan. 29, 2015
Payerpath Claim Submission Training for January 2015 Dec. 24, 2014
PayerPath Claim Submission Training for December 2014 Nov. 20, 2014
PayerPath Claim Submission Training for November 2014 Oct. 21, 2014
PayerPath Claim Submission Training for October 2014 Sept. 23, 2014
PayerPath Claim Submission Training for September 2014 Aug. 21, 2014
PayerPath Claim Submission Training for August 2014(Updated August 26, 2014) July 25, 2014
PayerPath Claim Submission Training July 10, 2014
EDI Announcement: Dual Use for 4010/5010 Formats Ends June 30, 2012 June 5, 2012
Anesthesia Services Claims Submitted Electronically (Updated May 31, 2012) May 4, 2012
EDI Announcement: Nevada Medicaid Version 5010 Solution Limits Diagnosis Codes on 837P Transactions. Apr. 30, 2012
EDI Announcement: Prepare for March 31, 2012, End Date for Dual Use of 5010 and D.0 Formats Jan. 25, 2012
Instructions for EDI Enrollment December 2011
Payerpath

Enrolled providers may submit electronic Nevada Medicaid and Nevada Check Up claims free of charge through Allscripts-Payerpath.

Service Center Directory

The Service Center Directory is a list of commercial clearinghouses currently registered with Hewlett Packard Enterprise. The list contains links to each clearinghouse’s web site.

Service Center Directory

Provider Billing Manual: EDI Chapter

The EDI chapter in the Provider Billing Manual provides answers to commonly asked EDI questions.

Read the chapter...

Service Center User Manual

The Service Center User Manual contains technical instructions for submitting and retrieving electronic transactions. This includes SFTP guidelines, transaction testing and handling login problems. EDI registration instructions are also included.

Service Center User Manual

EDI Companion Guides
Title Date
Transaction 270/271 - Health Care Eligibility Inquiry and Response February 2015
Transaction 271U – Unsolicited Transaction – HIPAA Version 5010 February 2013
Transaction 277U - Unsolicited 277 Claims Status Response - HIPAA Version 5010 October 2012
Transaction 820 - Health Care Premium Payment - HIPAA Version 5010 October 2012
Transaction 834 - Benefit Enrollment and Maintenance - HIPAA Version 5010 October 2012
Transaction 835 - Health Care Payment/Advice February 2015
Transaction 837D - Dental Health Care Claim - HIPAA Version 5010 October 2015
Transaction 837I - Institutional Health Care Claim - HIPAA Version 5010 October 2015
Transaction 837P - Professional Health Care Claim - HIPAA Version 5010 October 2015

The Companion Guides contain our HIPAA-compliant technical specifications for each transaction.