Nevada Medicaid and Nevada Check Up News (Third Quarter 2019 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


Urgent Notification:
Currently, some providers submitting Group Applications, Group Changes and Group Revalidations do not have the option in the Online Provider Enrollment system to select associated providers or change individual providers associated with the group. This is a known issue and a fix is being researched. In the meantime, providers can complete the Associate Provider list and submit it with the request. Individual applications are not impacted by this issue. The Associate Provider list is available at the following link:
https://www.medicaid.nv.gov
/HCP42/hp/ushc/docs/provider
/Associated%20Providers.pdf


Known Modernization System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2019 Claims. See Web Announcement 1979.

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

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
September 2019 For Review at September 26, 2019, Meeting: Angiotensin II Receptor Blockers (ARBs)
September 2019 For Review at September 26, 2019, Meeting: Antiemetics
September 2019 For Review at September 26, 2019, Meeting: Anti-inflammatory Agents – Misc., Topical
September 2019 For Review at September 26, 2019, Meeting: Anti-migraine Agents (Triptans)
September 2019 For Review at September 26, 2019, Meeting: Antivirals, Influenza
September 2019 For Review at September 26, 2019, Meeting: Antivirals, Topical
September 2019 For Review at September 26, 2019, Meeting: Attention-Deficit/Hyperactivity Disorder (ADHD) Agents
September 2019 For Review at September 26, 2019, Meeting: Atypical Antipsychotics
September 2019 For Review at September 26, 2019, Meeting: Biguanides
September 2019 For Review at September 26, 2019, Meeting: Calcitonin Gene Related Peptide (CGRP) Inhibitors
September 2019 For Review at September 26, 2019, Meeting: Calcium Channel Blockers
September 2019 For Review at September 26, 2019, Meeting: Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
September 2019 For Review at September 26, 2019, Meeting: Erythropoiesis Stimulating Agents
September 2019 For Review at September 26, 2019, Meeting: Hepatitis C Direct-Acting Antivirals
September 2019 For Review at September 26, 2019, Meeting: Immunomodulators
September 2019 For Review at September 26, 2019, Meeting: Inflammatory Bowel Disease Agents
September 2019 For Review at September 26, 2019, Meeting: Incretin Mimetics and Amylinomimetics
September 2019 For Review at September 26, 2019, Meeting: Inhaled Aminoglycosides
September 2019 For Review at September 26, 2019, Meeting: Insulin and Combination Agents
September 2019 For Review at September 26, 2019, Meeting: Macrolides
September 2019 For Review at September 26, 2019, Meeting: Meglitinides
September 2019 For Review at September 26, 2019, Meeting: Narcolepsy Agents
September 2019 For Review at September 26, 2019, Meeting: Omega-3 Fatty Acids
September 2019 For Review at September 26, 2019, Meeting: Opioids, Long Acting
September 2019 For Review at September 26, 2019, Meeting: Opioids, Short Acting
September 2019 For Review at September 26, 2019, Meeting: Opioid Use Disorder Agents
September 2019 For Review at September 26, 2019, Meeting: Proton Pump Inhibitors
September 2019 For Review at September 26, 2019, Meeting: Pulmonary Arterial Hypertension Agents
September 2019 For Review at September 26, 2019, Meeting: Respiratory Beta-Agonist Combination Agents
September 2019 For Review at September 26, 2019, Meeting: Scabicides and Pediculicides
September 2019 For Review at September 26, 2019, Meeting: Sodium-Glucose Cotransporter-2 Inhibitors
September 2019 For Review at September 26, 2019, Meeting: Statins (HMG-CoA Reductase Inhibitors)
September 2019 For Review at September 26, 2019, Meeting: Sulfonylureas
September 2019 For Review at September 26, 2019, Meeting: Thiazolidinediones
June 2019 For Review at June 27, 2019, Meeting: Attention-Deficit/Hyperactivity Disorder (ADHD) Agents
June 2019 For Review at June 27, 2019, Meeting: Anticonvulsants
June 2019 For Review at June 27, 2019, Meeting: Antidepressants, SSRI
June 2019 For Review at June 27, 2019, Meeting: Anti-inflammatory Agents – Misc., Topical
June 2019 For Review at June 27, 2019, Meeting: Insulin and Combination Agents
June 2019 For Review at June 27, 2019, Meeting: Levodopa Combinations
June 2019 For Review at June 27, 2019, Meeting: Multiple Sclerosis Agents
June 2019 For Review at June 27, 2019, Meeting: Ophthalmic Agents, Intraocular Pressure (IOP)-Modifying
June 2019 For Review at June 27, 2019, Meeting: Oral Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
June 2019 For Review at June 27, 2019, Meeting: Pulmonary Arterial Hypertension Agents
June 2019 For Review at June 27, 2019, Meeting: Respiratory Anticholinergics
June 2019 For Review at June 27, 2019, Meeting: Respiratory Beta-Agonists
June 2019 For Review at June 27, 2019, Meeting: Respiratory Beta-Agonists Combination Agents
June 2019 For Review at June 27, 2019, Meeting: Respiratory Corticosteroids
June 2019 For Review at June 27, 2019, Meeting: Topical Nonsteroidal Anti-inflammatory Drugs (NSAIDs)