Nevada Medicaid and Nevada Check Up News (Second Quarter 2020 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


Nevada Medicaid COVID-19

Nevada Health Response

Known Modernization System Issues-Click HERE

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 June 2020 Claims. See Web Announcement 2249.

Top Prior Authorization Denial Reasons for the Second Quarter of 2020. See Web Announcement 2254.

Top 10 Enrollment Return Reasons and Resolutions for June 2020 Submissions. See Web Announcement 2255.

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

Month Title
July 2020 E-Binder for July 2020 Meeting: Fee-For-Service
July 2020 E-Binder for July 2020 Meeting: Anthem Blue Cross and Blue Shield Healthcare Solutions
July 2020 E-Binder for July 2020 Meeting: Health Plan of Nevada (HPN)
July 2020 E-Binder for July 2020 Meeting: SilverSummit Healthplan
April 2020 E-Binder for April 2020 Meeting: Fee-For-Service (Updated April 8, 2020)
April 2020 E-Binder for April 2020 Meeting: Anthem Blue Cross and Blue Shield Healthcare Solutions
April 2020 E-Binder for April 2020 Meeting: Health Plan of Nevada (HPN)
April 2020 E-Binder for April 2020 Meeting: SilverSummit Healthplan
January 2020 E-Binder for January 2020 Meeting: Fee-For-Service
January 2020 E-Binder for January 2020 Meeting: Anthem Blue Cross and Blue Shield Healthcare Solutions
January 2020 E-Binder for January 2020 Meeting: Health Plan of Nevada (HPN)
January 2020 E-Binder for January 2020 Meeting: SilverSummit Healthplan
October 2019 E-Binder for October 2019 Meeting: Fee-For-Service
October 2019 E-Binder for October 2019 Meeting: Anthem Blue Cross and Blue Shield Healthcare Solutions
October 2019 E-Binder for October 2019 Meeting: Health Plan of Nevada (HPN)
October 2019 E-Binder for October 2019 Meeting: SilverSummit Healthplan
July 2019 E-Binder For July 2019 Meeting
April 2019 April 2019 Meeting: E-Binder
April 2019 April 2019 Meeting: Nevada Medicaid Annual DUR Survey FFY 2018
January 2019 E-Binder For January 2019 Meeting
October 2018 E-Binder For October 2018 Meeting
July 2018 E-Binder For July 2018 Meeting
April 2018 E-Binder For April 2018 Meeting
January 2018 E-Binder For January 2018 Meeting
October 2017 E-Binder For October 2017 Meeting
August 2017 E-Binder For August 2017 Meeting
April 2017 E-Binder For April 2017 Meeting
January 2017 E-Binder For January 2017 Meeting
October 2016 E-Binder For October 2016 Meeting
July 2016 E-Binder For July 2016 Meeting
April 2016 E-Binder For April 2016 Meeting
January 2016 E-Binder For January 2016 Meeting
November 2015 E-Binder For November 2015 Meeting
September 2015 E-Binder For September 2015 Meeting
April 2015 E-Binder For April 2015 Meeting
January 2015 E-Binder For January 2015 Meeting