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
Nov. 17, 2010 Agenda for December 16 Meeting
Oct. 28, 2010 For Review at December 16 Meeting: Oral Agents for Gout: Xanthine Oxidase Inhibitors
Oct. 28, 2010 For Review at December 16 Meeting: Ophthalmic Antibiotics: Macrolides
Oct. 28, 2010 For Review at December 16 Meeting: Pulmonary Arterial Hypertension Agents: PDE-5 Inhibitors
Oct. 28, 2010 For Review at December 16 Meeting: Pulmonary Arterial Hypertension Agents: Inhaled Prostacycline Analogues
Oct. 28, 2010 For Review at December 16 Meeting: Fibromyalgia
Oct. 28, 2010 For Review at December 16 Meeting: Sedative Hypnotics
Oct. 28, 2010 For Review at December 16 Meeting: Sedative Hypnotics – New Drug Update
Sept. 8, 2010 Agenda for September 23 Meeting
Aug. 5, 2010 For Review at September 23 Meeting: Antivirals, Influenza
Aug. 5, 2010 For Review at September 23 Meeting: Fibromyalgia
Aug. 5, 2010 For Review at September 23 Meeting: Ophthalmic Anti-Inflammatories
Aug. 5, 2010 For Review at September 23 Meeting: Platelet Aggregation Inhibitors
June 11, 2010 Agenda for June 24 Meeting
May 11, 2010 For Review at June 24 Meeting: Analgesics, Narcotic Long-Acting
May 11, 2010 For Review at June 24 Meeting: Analgesics, Narcotic Short-Acting
May 11, 2010 For Review at June 24 Meeting: Analgesics-Anesthetics, Topical
May 11, 2010 For Review at June 24 Meeting: Angiotensin Modulators Combinations
May 11, 2010 For Review at June 24 Meeting: Antimigraine Agents, Triptans
May 11, 2010 For Review at June 24 Meeting: Antiparkinson's Agents
May 11, 2010 For Review at June 24 Meeting: Bladder Relaxant Preparations
May 11, 2010 For Review at June 24 Meeting: Cytokine and CAM Antagonists and Related Agents
May 11, 2010 For Review at June 24 Meeting: Glucocorticoids, Inhaled
May 11, 2010 For Review at June 24 Meeting: Growth Hormone
May 11, 2010 For Review at June 24 Meeting: Intranasal Rhinitis Agents
May 11, 2010 For Review at June 24 Meeting: Multiple Sclerosis Agents
May 11, 2010 For Review at June 24 Meeting: New Drug Update - Ampyra
May 11, 2010 For Review at June 24 Meeting: Ophthalmics for Allergic Conjunctivitis
May 11, 2010 For Review at June 24 Meeting: Otic Antibiotics
May 11, 2010 For Review at June 24 Meeting: Sedative Hypnotics
May 11, 2010 For Review at June 24 Meeting: Self-injectable Epinephrine Agents
Apr. 9, 2010 Agenda for May 3 Meeting
Mar. 19, 2010 Agenda for March 25 Meeting
Mar. 18, 2010 For Review at May 3 Meeting: Anticonvulsants, Oral
Mar. 18, 2010 For Review at May 3 Meeting: Antipsychotics
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Alpha-Glucosidase Inhibitors
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Incretin Enhancers/Mimetics
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Insulins
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Meglitinides
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Metformins
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Sulfonylureas
Mar. 18, 2010 For Review at May 3 Meeting: Hypoglycemics, Thiazolidinediones (TZDs)
Feb. 8, 2010 For Review at March 25 Meeting: Psoriasis Agents, Topical
Feb. 8, 2010 For Review at March 25 Meeting: Acne Agents, Topical
Feb. 8, 2010 For Review at March 25 Meeting: Androgenic Agents
Feb. 8, 2010 For Review at March 25 Meeting: Fluoroquinolones, Oral
Feb. 8, 2010 For Review at March 25 Meeting: Lipotropics, Other
Feb. 8, 2010 For Review at March 25 Meeting: Proton Pump Inhibitors

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