Nevada Medicaid and Nevada Check Up News (Fourth 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


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 December 2019 Claims. See Web Announcement 2073.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2019. See Web Announcement 2072.

Top 10 Enrollment Return Reasons and Resolutions for November and December 2019 Submissions. See Web Announcement 2071.

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

Announcements
Notice Date Title
Dec. 30, 2019 Diabetic Supply Policy Changes for Nevada Medicaid
Dec. 4, 2019 Diabetic Supply Policy Changes for Nevada Medicaid
Nov. 14, 2019 Diabetic Supply Policy Changes for Nevada Medicaid
Dec. 22, 2017 Diabetic Supply Changes for Nevada Medicaid (Effective January 1, 2018)
Jan. 10, 2017 Diabetic Supply Changes for Nevada Medicaid
March 12, 2014 Product Recall from Abbott Diabetes Care: FreeStyle Flash® and FreeStyle® Blood Glucose Meters
Dec. 9, 2013 Urgent Product Recall from Abbott Diabetes Care: FreeStyle® and FreeStyle Lite® Blood Glucose Test Strips
Dec. 30, 2010 Urgent Product Recall Effective December 22, 2010: Blood Glucose Test Strips from Abbott Diabetes Care
Oct. 14, 2010 Policy Clarification for PT 28 and PT 33 Providers of Diabetic Supplies
Feb. 3, 2009 Diabetic Supply Program Begins March 1, 2009
Billing and Product Information
Notice Date Title
July 16, 2019 Billing Information and Covered Diabetic Supplies (Effective January 1, 2019)
Dec. 15, 2017 Billing Information and Covered Diabetic Supplies (Effective January 1, 2018)
Jan. 10, 2017 Billing Information and Covered Diabetic Supplies (Effective January 1, 2017)
Communications
Notice Date Title
Dec. 15, 2017 FAQs for Recipients (Updated for January 1, 2018, effective date)
June 18, 2013 FAQs for Recipients (Updated June 18, 2013)
Feb. 3, 2009 Letter to Prescribers
Feb. 3, 2009 Letter to Pharmacies
Feb. 3, 2009 Letter to Recipients
Resources
Title
Medicaid Services Manual, Chapter 1200
Abbott Diabetes Care, Inc.
LifeScan Inc., a Johnson & Johnson company