Nevada Department of
Health and Human Services
Division of Health Care Financing and Policy Portal
Nevada Medicaid and Nevada Check Up News (Second 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:The following Nevada Medicaid Provider Web Portal services will be unavailable from 7 p.m. to midnight Pacific Time Sunday, July 20, 2025, for scheduled maintenance:
Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page
Multi-Factor Authentication Frequently Asked Questions
Known System Issues-Click HERE
Top 10 Claim Denial Reasons and Resolutions/Workarounds for June 2025 Professional Claims. See Web Announcement 3675.
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.
- Secure Provider Web Portal (PWP), which includes:
- Recipient Eligibility
- Provider Claim Appeals
- Prior Authorization (PA) system
- Claims Submission
- Online Provider Enrollment (OPE)
- Provider Flex
- Gabby®, which includes:
- Gainwell Technologies 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 now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page
Multi-Factor Authentication Frequently Asked Questions
Known System Issues-Click HERE
Top 10 Claim Denial Reasons and Resolutions/Workarounds for June 2025 Professional Claims. See Web Announcement 3675.
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