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

Behavioral Health Providers Invited to Attend Monthly DHCFP Webinars [See Web Announcement 1628]

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 Notice for Behavioral Health Providers: Upcoming Moratorium on Enrollment for Specialty 301 (Qualified Mental Health Associates) and Specialty 302 (Qualified Behavioral Aides) [See Web Announcement 1746]

Modernization: Dates All Providers and Delegates Need to Know to Prepare for Paperless Processes [See Web Announcement 1733]

Modernization: Trading Partner Enrollment and Certification (Testing) Must Be Completed Immediately to Avoid Any Service Interruptions [See Web Announcement 1766]

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

Effective January 12, 2019, all providers will be required to submit their Provider Enrollment Applications electronically via the Online Provider Enrollment (OPE) Tool at https://www.medicaid.nv.gov/hcp42/provider/Home/tabid/477/Default.aspx, as paper enrollment applications will no longer be accepted with the go-live of the new modernized Medicaid Management Information System (MMIS). Please continue to review the modernization-related web announcements at https://www.medicaid.nv.gov/providers/Modernization.aspx for further details.

Thank you for your interest in the Nevada Medicaid and Nevada Check Up Program. This page contains all of the information and forms you will need to become a Nevada Medicaid provider. If you have any questions, please contact the Provider Enrollment Unit at (877) 638-3472 from 8a.m. to 5p.m. Monday through Friday.


Effective 12/1/2015, access Online Provider Enrollment for individual, group or OPR enrollments.


Provider Documentation Reminders: (See Web Announcement 1125 for reminders that will assist providers in adhering to the documentation responsibilities required of each Nevada Medicaid/Nevada Check Up provider.)


All enrollment documents including attachments require an original signature from the provider or an authorized representative (use dark blue or black ink).


Required Enrollment Documents
Online Provider Enrollment User Manual
Initial Enrollment Documents
Revalidation Documents and Reports
Ordering, Prescribing and Referring Provider Enrollment Documents
Hospital Presumptive Eligibility Documents
  • Web Announcement 1526:Hospital Presumptive Eligibility Annual Training Calendar Dates and Sign-up Guidelines for 2018 (Posted February 16, 2018)
  • Web Announcement 1408:Hospital Presumptive Eligibility Annual Training Calendar Dates and Sign-up Guidelines for the Remainder of 2017 and Early 2018 (Posted July 17, 2017)
  • Web Announcement 1008: Attention ALL Hospital Presumptive Eligibility Providers: Guidance Policy Available
  • Web Announcement 861 with Training Schedule: Implementation of Hospital Presumptive Eligibility Option for Acute Care Hospitals (Provider Types 11 and 75)
  • Nevada Medicaid Hospital Presumptive Eligibility Provider Addendum: Qualified hospitals must complete and submit the Nevada Medicaid Hospital Presumptive Eligibility Provider Addendum.
  • Hospital Presumptive Eligibility Training Sign-Up Sheet: Complete this form listing the hospital employees that will be attending the mandatory training for Presumptive Eligibility. You will be notified by the DWSS in regards to the training dates and times. Keep in mind that each employee making PE determinations MUST be trained by DWSS and complete a competency examination prior to making ANY determinations.
Recommended Enrollment Documents
Changes to Provider Information

Changes to any information presented on your enrollment documents must be reported to Nevada Medicaid within five business days.

  • To complete changes online, please login to the Secure Web Portal, and choose “Revalidate-Update Provider”.
  • To report a change in business ownership, resubmit a completed Provider Enrollment Application.
  • For all other changes, the Provider Information Change Form (FA-33) may be used.
Mailing Address

Mail completed enrollment forms and required documentation to Nevada Medicaid, Provider Enrollment Unit, P.O. Box 30042, Reno, NV 89520-3042