Nevada Medicaid and Nevada Check Up News (First Quarter 2025 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

NOTIFICATION: Known Issue with Resubmitting Returned to Provider (RTP) Applications
This issue has been resolved, and the impacted applications have been placed in the appropriate status for review.

Provider Flex is coming soon!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Attention Provider Types 24, 72, 74, and 77:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from April 14, 2025 – April 21, 2025. Please refer to Web Announcement 3595 for details.

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2025 Professional Claims. See Web Announcement 3593.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2024. See Web Announcement 3458.

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

Notice Date Title
Dec. 13, 2012 For Review at January 24 Meeting: Colony-Stimulating Factors
Dec. 13, 2012 For Review at January 24 Meeting: Hereditary Angioedema Agents
Dec. 13, 2012 For Review at January 24 Meeting: Potassium Channel Blockers
Dec. 13, 2012 For Review at January 24 Meeting: Serotonin and Norepinephrine Reuptake Inhibitors
Dec. 13, 2012 For Review at January 24 Meeting: Short-Acting Opioids
Oct. 19, 2012 For Review at October 25 Meeting - Cymbalta
Oct. 19, 2012 For Review at October 25 Meeting - DUR utilization
Oct. 19, 2012 For Review at October 25 Meeting - Forteo
Oct. 19, 2012 For Review at October 25 Meeting - Long acting opioids
Oct. 19, 2012 For Review at October 25 Meeting - Marinol
Oct. 19, 2012 For Review at October 25 Meeting - Omontys
Oct. 19, 2012 For Review at October 25 Meeting - Prolia
Oct. 19, 2012 For Review at October 25 Meeting - promethazine with codeine util
Oct. 19, 2012 For Review at October 25 Meeting - Short acting opioids
Oct. 19, 2012 For Review at October 25 Meeting - top 10 produr edits
July 23, 2012 For Review at July 26 Meeting: DUR Board Reports July 2012
July 23, 2012 For Review at July 26 Meeting: DUR Standard Reports July 2012
July 23, 2012 For Review at July 26 Meeting: Acetaminophen-Containing Products
July 23, 2012 For Review at July 26 Meeting: Anticonvulsants-Benzodiazepines
July 23, 2012 For Review at July 26 Meeting: Atypical (Second-Generation) Antipsychotics
July 23, 2012 For Review at July 26 Meeting: Incretin Mimetics
July 23, 2012 For Review at July 26 Meeting: Kalydeco®
July 23, 2012 For Review at July 26 Meeting: Neuropathic Pain Agents
July 23, 2012 For Review at July 26 Meeting: Oral Anticoagulants
July 23, 2012 For Review at July 26 Meeting: Phosphodiesterase (PDE) 4 Inhibitors
July 23, 2012 For Review at July 26 Meeting: Platelet Inhibitors
July 23, 2012 For Review at July 26 Meeting: Scabicides and Pediculicides
July 19, 2012 Agenda for July 26 Meeting
Dec. 30, 2011 Agenda for January 26 Meeting

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