Nevada Department of
Health and Human Services
Division of Health Care Financing and Policy Portal
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
Gainwell Technologies is currently aware of an issue affecting the ability to resubmit applications that have been Returned to Provider (RTP’ed). Gainwell is actively investigating the problem. This notification will be updated as soon as the issue is resolved. Thank you for your patience and understanding.
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.
Gainwell Technologies is currently aware of an issue affecting the ability to resubmit applications that have been Returned to Provider (RTP’ed). Gainwell is actively investigating the problem. This notification will be updated as soon as the issue is resolved. Thank you for your patience and understanding.
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.
Provider Links
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