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

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]

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Notifications

Urgent: The adjudication of claims for physician-administered drugs submitted last week may be delayed due to a claims processing issue. The claims may pend with edit code 0899 (National Drug Code (NDC) claims are pending during transition period) on remittance advices dated June 22, 2018. This notification will be updated when the issue is resolved and when the claims are processed.

Attention Electronic Billing Trading Partners: Preparations Continue for the Medicaid Management Information System Modernization Project – Inbound Companion Guides Now Available. [See Web Announcement 1617]

Attention All Providers and Electronic Billing Trading Partners: Medicaid Management Information System Enhancements Will Improve Claims and Enrollment Processes. [See Web Announcement 1559]

The Division of Health Care Financing and Policy (DHCFP) has selected LIBERTY Dental Plan of Nevada (LIBERTY) as the new Managed Care Dental Benefits Administrator (DBA) effective January 1, 2018, to serve recipients enrolled in a Managed Care Organization (MCO). [See Web Announcement 1442]

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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

Pharmacy Prescriber List

The Centers for Medicare & Medicaid Services (CMS) has made available National Plan and Provider Enumeration System (NPPES) health care provider data via the internet. User IDs and passwords are not required and access to the data is free.


The NPI Registry and the NPPES Downloadable File are tools Nevada Medicaid pharmacy providers may use to obtain a physician’s National Provider Identifier (NPI) when entering the prescriber’s ID on claims.


The NPI Registry and the NPPES Downloadable File are accessible via the following links: