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

Nevada Medicaid/Nevada Check Up Fee For Service providers may save valuable time, build staff efficiency and enhance the safety of the prescribing process by establishing an electronic prescribing connection with pharmacies. Electronic prescribing, also referred to as e-prescribing, is the exchange of prescription information through computer-to-computer connections, instead of issuing prescriptions by paper, fax or phone. The computer-to-computer process is safer and more secure for recipients, prescribers and pharmacies, because paper faxes are eliminated.


An additional money-saving benefit for providers who use e-prescribing is that they are exempt from the tamper-resistant prescription pad requirements in effect for all written, non-electronic prescriptions for Medicaid Fee For Service outpatient drugs.


Nevada Medicaid/Nevada Check Up providers who use electronic prescribing now have access to data that will assist them in managing prescriptions for recipients more efficiently. Information the Division of Health Care Financing and Policy (DHCFP) and Nevada Medicaid have made available through prescribers’ practice management software vendors includes:


  • Recipient pharmacy claims history
  • Eligibility data
  • Indication of the need for prior authorization


The recipient data provided by DHCFP and Nevada Medicaid to software vendors is transmitted via technologies that are compliant with Health Insurance Portability and Accountability Act (HIPAA) security requirements.


Contact your practice management software vendor to enable your system for Nevada Medicaid/Nevada Check Up e-prescriptions. The functionality of your system is determined by your software vendor.

The following websites offer detailed information and assistance to prescribers and pharmacies:


www.GetRxConnected.com
Visit this website to complete a short practice compatibility assessment to determine if your practice has the ability to establish a direct electronic connection with pharmacy computers.


www.surescripts.com
Visit the SureScripts® website for steps prescribers and pharmacies can take to get set up to send and receive e-prescriptions (at this website select “Pharmacies” or “Physicians” from the menu bar). This website also contains support information, best practices, communication tools, a list of activated pharmacies in your area and other resources. SureScripts operates the Pharmacy Health Information Exchange™, which facilitates the secure electronic transmission of prescription information between physicians and pharmacists through the provider’s practice management software.

Resources for additional information:

Call SureScripts at 1-866-RxReady or 1-866-797-3239 for questions about electronic prescribing connectivity.

Review the Frequently Asked Questions for answers to a variety of electronic prescribing issues.

Notes:

  • All practice management software vendors who provide e-prescribing software in Nevada must be certified by the Nevada State Board of Pharmacy.
  • Prescribers are responsible for assuring the confidentiality and security of the recipient’s information through e-prescribing.