URGENT Electronic Visit Verification (EVV) Claims Message: EVV claims submitted through Sandata between noon Pacific Time on Monday, April 8, 2024, and 6 a.m. Pacific Time on Tuesday, April 9, 2024, were received for processing by Gainwell on Wednesday, April 17, 2024. As a result, payment of the impacted claims will be unfortunately delayed by one week and paid April 26, 2024, instead of April 19, 2024. No action is required on your part. Nevada Medicaid is working to avoid this happening again in the future and apologizes for the inconvenience this payment delay causes during this period of EVV claim submission challenges because of the Change Healthcare cyber security event.

Electronic Visit Verification (EVV) Claim Update: Providers using Sandata for claims submission are advised to allow 24 hours after claim submission for claim details to be visible in the Medicaid Management Information System (MMIS). Please be advised that claims must be submitted before noon Pacific Time on Fridays to be included in the following weeks’ remittance advice.

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, April 28, 2024, for scheduled maintenance:

• Secure Provider Web Portal (Electronic Verification System – EVS), which includes:
  • Recipient Eligibility
  • Provider Claim Appeals
  • Prior Authorization (PA) system
  • Claims Submission
• Online Provider Enrollment (OPE)
• Gabby®, which includes:
  • Customer Service Center (877) 638-3472
  • Automated Response System (ARS) (800) 942-6511
• Real time CAQH/CORE EDI eligibility and claim verification
• Provider PASRR

Unwinding COVID-19 Information

Known System Issues-Click HERE

Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System Survey

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.