Nevada Medicaid Contact List Print This Page
General Information
Customer Service Center
Claim inquiries and general information
Mailing Address:
Nevada Medicaid
Customer Service
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472
Nevada Medicaid Central Office
State policy inquiries and Fair Hearing requests
Mailing Address:
1100 East William St.
Suite 102
Carson City, NV 89701
Phone: (877) 638-3472 and (775) 684-3600
Medicaid Recipient Customer Service
Las Vegas District Office: (702) 668-4200
Reno District Office: (775) 687-1900
All other areas: (866) 569-1746
Automated Response System (ARS)
Recipient eligibility, recent payments, claim status, and prior authorization information via phone
Phone: (800) 942-6511
Electronic Verification System (EVS)
Recipient eligibility, claim status, prior authorization status, provider payments
Note: For EVS, there can only be one provider administrator for each NPI/FEIN/zip code. The provider administrator must register as a “Provider” and will be responsible for creating delegates for that provider. If you do not know who is the provider administrator is in your office, call the Customer Service Center at (877) 638-3472.
Web Sites
Nevada Medicaid Web Site
Web announcements, billing manual, billing guidelines, forms, pharmacy information
DHCFP Web Site
Medicaid Services Manual, rates, policy updates, public notices
Provider Training
Mailing Address:
Nevada Medicaid
Provider Training
P.O. Box 30042
Reno NV 89520-3042
E-mail: NevadaProviderTraining@gainwelltechnologies.com
Electronic Billing
Mailing Address:
Nevada Medicaid
EDI Coordinator
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Electronic Billing")
E-mail: NVMMIS.EDIsupport@gainwelltechnologies.com
Managed Care Organizations (MCOs)
The Nevada Medicaid and Nevada Check Up contracted Managed Care Organizations (MCOs) are Anthem Blue Cross and Blue Shield Healthcare Solutions, Health Plan of Nevada and SilverSummit Healthplan. LIBERTY Dental Plan of Nevada is the Dental Benefits Administrator (DBA).
Anthem Blue Cross and Blue Shield Healthcare Solutions
Provider Website: https://providers.anthem.com/nevada-provider/home
Provider Services Phone: 844-396-2330
Provider Contracting: https://providers.anthem.com/nevada-provider/join-our-network
Claims: https://providers.anthem.com/nevada-provider/claims
Payor ID: 00265
Mailing Address:
Anthem Blue Cross and Blue Shield Healthcare Solutions
Attn: Nevada Claims
P.O. Box 61010
Virginia Beach, VA 23466-1010
Precertification: https://providers.anthem.com/nevada-provider/resources/precertification-requirements
Member Services Phone: 844-396-2329
Member Website: https://mss.anthem.com/nevada-medicaid/home.html
Health Plan of Nevada (HPN)
Provider Relations and Provider Contracting
Phone: (702) 242-7088 or (800) 745-7065
Website: https://myhpnmedicaid.com/Provider
Member Services
Phone: (800) 962-8074
Fax: (702) 240-6281
Claims Address
Health Plan of Nevada
P.O. Box 15645
Las Vegas, NV 89114
EDI Claims Submission Clearinghouse:
OptumInsight
1755 Telstar Drive #400
Colorado Springs, CO 80920
Payor ID’s:
Claims – Payor ID 76342
Encounter Data – Payor ID 76343
LIBERTY Dental Plan of Nevada
Provider Relations and Provider Contracting
Phone: (888) 700-0643
Email: prinquiries@libertydentalplan.com
Website: www.libertydentalplan.com/NVMedicaid
Member Services
Phone: (866) 609-0418
Website: www.libertydentalplan.com/NVMedicaid
Claims Address
LIBERTY Dental Plan of Nevada
Attn: Claims
P.O. Box 401086
Las Vegas, NV 89140
Payor ID: CX083
Molina Healthcare of Nevada, Inc.
Provider Contracting
Phone: (833) 685-2103
Email: MHNVProviderContracting@molinahealthcare.com
Fax: (833) 908-4412
Provider Website
Website: https://www.molinahealthcare.com/providers/nv/medicaid/home.aspx
Member Services
Phone: (833) 685-2102
Claims Submission
Website: https://www.molinahealthcare.com/providers/nv/medicaid/claims/submission.aspx
EDI Claims Submission Clearinghouse:
Change Healthcare
Payer ID: MLNNV
Claims Address
Molina Healthcare of Nevada, Inc.
P.O. Box 22666
Long Beach, CA 90801
SilverSummit Healthplan
Provider Contracting
Phone: (844) 366-2880
Email: NetworkManagement@SilverSummitHealthPlan.com
Website: https://www.silversummithealthplan.com
Provider Inquiry Telephone Numbers
Medical/Behavioral Health: (844) 366-2880
Pharmacy: (844) 366-2880
Pharmacy (Prior Authorization): (855) 565-9520
Vision: (855) 896-8572
Claims Addresses
Medical/Behavioral Health:
P.O. Box 5090
Farmington, MO 63640
Pharmacy:
5 River Park Place E, Suite 210:
Fresno, CA 93720
Vision:
Attn: Claims Processing
P.O. Box 7548
Rocky Mount, NC 27804
Fax Numbers
Prior Authorization Requests: Medical: (844) 367-7022 Behavioral Health: (855) 868-4940 Pharmacy: (866) 399-0929
Medical Records (for nurse use) (844) 518-7889
Admissions Census/Facesheets (844) 868-7399
Concurrent Review (844) 755-1370
Case Management (844) 851-1023
Medical Management General (844) 367-7015
Nevada Quality Improvement (855) 565-9517
Nevada Grievance and Appeals (855) 742-0125
Provider Enrollment
Mailing Address:
Nevada Medicaid
Provider Enrollment
P.O. Box 30042
Reno, NV 89520-3042
Phone: (877) 638-3472 (select option for "Provider Enrollment")
Prior Authorization
Prior Authorization
Phone: (800) 525-2395
Prior Authorization for Dental
Nevada Medicaid
"Dental PA"
P.O. Box 30042
Reno, NV 89520-3042
Phone: (800) 525-2395
Prior Authorization for All Other Service Types (except Pharmacy)
Phone: (800) 525-2395
Pharmacy
Customer Service Center
Pharmacy Prior Authorization and Technical Call Center
Phone: (800) 695-5526
Medicaid Customer Service
Medicaid Recipient Inquiries
Phone: (702) 668-4200 or (775) 687-1900
Prime Therapeutics State Government Solutions
Submit prior authorization requests online for prescription drugs. Select "Prime Therapeutics State Government Solutions" from the "Pharmacy" menu on this web site or visit Prime Therapeutics State Government Solutions at https://nv.primetherapeutics.com/home.
Public Hearings
Providers are welcome to attend public hearings and voice their opinion on policy changes. Call the number below to receive electronic or written notices of scheduled public hearings.
Phone: (775) 684-3681
PASRR/LOC
Phone: (800) 525-2395
Fax: (855) 709-6847
Third Party Liability (TPL) Identification and Recovery
If you believe a recipient's private insurance or Medicare Replacement records are incorrect, please contact Health Management Systems, Inc. (HMS) at:
Third Party Referral (TPR)
Only TPL update, add and termination requests:
Toll Free: (855) 528-2596
Email: nvtpl@gainwelltechnologies.com
NOTE: When emailing HMS, “escalation” should be included in the subject line and the email request must include Recipient Name, Date of Birth (DOB), Medicaid ID, and commercial policy information.
Direct Bill and Commercial Insurance
(888) 831-2715
Medicare Disallowance
(877) 640-3420
Email: prdoc@gainwelltechnologies.com
Casualty/Subrogation
(888) 378-2836
Email: NVCasualty@gainwelltechnologies.com
Health Insurance Premium Payment Program (HIPP)
(877) 640-3413
Email: mynvhippcustomerservice@gainwelltechnologies.com
Credit Balance Audit (CBA)
(469) 897-4918
Email: CBANevadaMedicaid@gainwelltechnologies.com
Payment Analytics (PA)
(877) 248-8523
Provider Portal: https://hmsportal.hms.com
If you believe a recipient's Medicare record is incorrect, please contact the DHCFP at:
Email: TPL@dhcfp.nv.gov