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Health Plan of Nevada Medicaid Plan

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    • Case Management
    • CME Credits
    • Empanelment Reports
    • Disease Management
    • Fraud Waste and Abuse
    • Health Education and Wellness
    • Join Our Network
    • Online Provider Center
    • Pharmacy Benefits
    • Prior Authorizations
    • Provider Advocates
    • Provider Memos Letters and Forms
    • Provider Summary Guide
    • Provider Training (PDF)
    • Review Protocols
    • Lista de medicamentos (PDF)
    • Searchable Drug List
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Provider Memos Letters and Forms

Download and print the information you need.

  • Important Information Regarding HPN Medicaid/Nevada Check-Up Perinatology Provider Change (PDF)
  • Medicaid Flu Vaccine Incentive for 2019 (PDF)
  • Medicaid Vaccines Reminder (PDF)
  • Medicaid Appointment Availability Standards including Behavioral Healthcare Options Quick Reference Guide (PDF)
  • Web Announcement 1847: Revalidate/Update Provider Information Process (PDF)
  • Revalidation Report for Providers (PDF)
  • Maternity Risk Screening Form (PDF)
  • Adult Wellness Visits (PDF)
  • Sports Physicals Claim Codes Letter (PDF)
  • Well-Child, Sick Child Fax Memo (PDF)
  • Behavioral Healthcare Options Substance Abuse Outpatient Treatment Request Form (PDF)
  • Closing the Referral Loop Memo (PDF)
  • Primary Care Physician Change Form (PDF)
  • Transplant Referral Fillable Form (PDF)

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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