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

Notice Date Title
October 2018 For Review at October 18, 2018 Meeting: Calcitonin Gene Related Peptide (CGRP) Inhibitors
October 2018 For Review at October 18, 2018 Meeting: Immunomodulators
July 2018 For Review at July 26, 2018 Meeting: Anti-inflammatory Agents – Misc., Topical
July 2018 For Review at July 26, 2018 Meeting: Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Modulators and Dornase Alfa
July 2018 For Review at July 26, 2018 Meeting: Hepatitis C Direct-Acting Antivirals
July 2018 For Review at July 26, 2018 Meeting: Irritable Bowel Syndrome and Constipation Agents
April 2018 For Review at April 26, 2018 Meeting: Gonadotropin-Releasing Hormone (GnRH) Agonists / Luteinizing Hormone-Releasing Hormone (LHRH) Agonists
April 2018 For Review at April 26, 2018 Meeting: Hepatitis C Direct-Acting Antivirals
April 2018 For Review at April 26, 2018 Meeting: Makena® (Hydroxyprogesterone Caproate)
January 2018 For Review at January 25, 2018 Meeting: Anticoagulants, Oral
January 2018 For Review at January 25, 2018 Meeting: Austedo™ (Deutetrabenazine)
January 2018 For Review at January 25, 2018 Meeting: Benlysta (Belimumab)
January 2018 For Review at January 25, 2018 Meeting: Hepatitis C Direct-Acting Antivirals
January 2018 For Review at January 25, 2018 Meeting: Immunomodulators
January 2018 For Review at January 25, 2018 Meeting: Irritable Bowel Syndrome and Constipation Agents
2017 All 2017 Meetings
2016 All 2016 Meetings
2015 All 2015 Meetings
2014 All 2014 Meetings
2013 All 2013 Meetings
2012 All 2012 Meetings
2011 All 2011 Meetings
2010 All 2010 Meetings
2009 All 2009 Meetings
2008 All 2008 Meetings
2007 All 2007 Meetings
2006 All 2006 Meetings