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For Members
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Looking for a plan?
What is Medicaid?
Health Plan of Nevada Medicaid Plan

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    • Case Management
    • Clinical Guidelines
    • Continuing Medical Education (CME) Credits
    • Counting Kicks During Pregnancy
    • Credentialing
    • Empanelment Reports
    • Fraud Waste and Abuse
    • Health Equity
    • HEDIS Measures
    • Influenza (Flu) Vaccine Decision-Making Guide
    • Join Our Network
    • Long-Acting Injectable Medications
    • Medical Policies
    • Medical Policies - Nevada Only
    • Online Provider Center
    • Opioid Programs and Resources
    • Pharmacy Benefits
    • Prior Authorizations
    • Provider Advocates
    • Provider Memos, Letters and Forms
    • Provider Summary Guide
    • Provider Training (PDF)
    • Review Protocols
    • Tip Sheet: Get Adults’ Vaccinations Back on Track (PDF)
    • Drug List (PDF)
    • Searchable Drug List
    • Doctor / Provider
    • Pharmacy
    • Vision
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Provider Memos, Letters and Forms

Download and print the information you need.

  • Important Information Regarding CPT Category II Coding Incentive Program (PDF)
  • Important Information Regarding EPSDT Services (PDF)
  • Understanding Patient Satisfaction Reporting (PDF)
  • Update to Health Plan of Nevada Medicaid’s Prenatal and Postpartum Bonus Program (PDF)
  • Medicaid Appointment Availability Standards including Behavioral Healthcare Options Quick Reference Guide (PDF)
  • Maternity Risk Screening Form (PDF)
  • Well-Child, Sick Child Fax Memo (PDF)
  • Primary Care Physician Change Form (PDF)
  • Transplant Referral Fillable Form (PDF)

For Medicaid related forms provided by the Nevada Department of Health and Human Services, please visit medicaid.nv.gov.

If you do not find the information you’re looking for, please call 702-242-7088 or toll-free at 1-800-745-7065, Monday through Friday, 8 a.m. to 5 p.m. local time.

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