Medicaid Fiscal Agent Transition
The Nevada Division of Health Care Financing and Policy (DHCFP) has selected a new fiscal agent, Nevada Medicaid. The following documents contain information regarding the fiscal agent transition.
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
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 Not Implemented in Provider Flex:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from June 30, 2025 – July 7, 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 May 2025 Professional Claims. See Web Announcement 3651.
Top Prior Authorization Denial Reasons for the First Quarter of 2025. See Web Announcement 3630.
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
