Nevada Medicaid and Nevada Check Up News (First Quarter 2024 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

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

Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.

Unwinding COVID-19 Information

Known System Issues-Click HERE

Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System Survey

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2024 Professional Claims. See Web Announcement 3361.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See Web Announcement 3280.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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

Monday
8:00PM - 12:00AM


Nevada Medicaid Now Offering Digital Health Information Access


For the first time, Nevadans enrolled in Medicaid can now download the new NVMedicaid app for instant access to their health information and Medicaid Card. The NVMedicaid App is only available to members 18 and over.The app has several features for recipients including:


  • View their health plan
  • Procedures
  • Contact information
  • Access resources
  • Review claims information
  • Search for providers
  • Receive broadcast messages

The app also allows recipients to receive messages from NV Medicaid and quickly find providers in their network.


NVMedicaid is a web based application and can be accessed online at https://mdp.medicaid.nv.gov/


The State developed the app in partnership with contractor Gainwell Technologies. The app, called “NVMedicaid” is available on the Apple App Store, and Google Play. People enrolled in Medicaid can access their claims information and Medicaid card, meaning there is no need to carry a physical card anymore.


Health data is federally protected, so Medicaid recipients must sign up for data-sharing. For more information, please visit: https://dhcfp.nv.gov/Resources/MDPResource/

Nevada Medicaid Recipient Resources:

Access the NVMedicaid Application Provider Guide for detailed information on how to download and use the NVMedicaid App.


Visit https://dhcfp.nv.gov/Resources/MDPResource/ for more information about accessing health information through apps.


For more info: English NV Medicaid App

For more info: Spanish NV Medicaid App


Nevada Medicaid and the Division of Welfare and Supportive Services have an easy way for members to update their address. Simply follow the link to complete the form https://dhcfp.nv.gov/UpdateMyAddress/

Do you need free or low-cost medical care or are you struggling with medical bills?

We are here to help. Visit this web site to apply today: https://accessnevada.dwss.nv.gov/


If you are not eligible for Medicaid, check your eligibility through Nevada Health Link, which offers subsidies and tax credits to cover monthly health insurance costs. Visit this web site to apply today: https://NevadaHealthLink.com or call 1-800-547-2927.


Nevada Medicaid offers free or low-cost health insurance for working Nevadans, people who have lost their jobs, or have become too sick to work. We support low-income families, children, seniors, and people with disabilities. We offer financial protection against bankruptcy for families who are struck by unexpected illness. We make health care possible in many urban and rural communities. It's always open enrollment at Nevada Medicaid, apply at Access Nevada, or call 1-800-992-0900.