NOTIFICATION:The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, May 11, 2025, for scheduled maintenance:

• Secure Provider Web Portal (PWP), which includes:
  • Recipient Eligibility
  • Provider Claim Appeals
  • Prior Authorization (PA) system
  • Claims Submission
• Online Provider Enrollment (OPE)
• Gabby®, which includes:
  • Contact Center (877) 638-3472
  • Automated Response System (ARS) (800) 942-6511
• Real time CAQH/CORE EDI eligibility and claim verification
• Provider Pre-Admission Screening Resident Review (PASRR)
• Trading Partner File Transfer (EDI/SFTP)
• Business Partner File Transfer (EDI/SFTP)

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

Attention Provider Type 20:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for this provider type from May 5, 2025 – May 12, 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 March 2025 Professional Claims. See Web Announcement 3616.

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.