LAS VEGAS (KTNV) — The Nevada Health Authority says they’re experiencing what they say is a typical delay this time of the year with processing Medicaid revalidation applications.
NVHA director Stacie Weeks said there are about 450 applications from providers in their queue right now.
“We are going to go back and make sure there's nothing we're missing on efficiencies. We're going to be working closely with our vendor who helps us process these applications,” she said.
Weeks suggests everyone start as early as possible with their application process, so they don’t experience a lapse in their contract.
But with that context, comes the reality some providers here in the Las Vegas Valley tell us they’re facing.
Last week, Channel 13 heard from Emily Swogger, a speech-language pathologist who came to us after feeling she had nowhere else to turn.
She was operating without an active contract for four days when we got involved and brought her concern to the state. She’s now active and will be getting paid for the days she provided services to her clients out of contract.
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Clinical social worker Ladwana Retic’s clients saw our reporting and told her to contact Channel 13, because she’s been operating without a Medicaid contract since May 20.
Ladwana Retic turns to Channel 13 when Medicaid revalidation delay leaves her seeing patients for free:
For her seven private clients each week, she provides services to help them heal from all types of trauma.
“This could be complex trauma, where there’s been things going on over the years, or something as simple as 'I was in a car accident and I can’t drive anymore,'” she explained.
Medicaid reimburses her about $700 per week for her services. But since May 20, she’s been seeing patients for free.
“I’m not interested in abandoning my clients. Especially, I know their histories, I know what they’ve gone through. Most of them have abandonment issues, so that’s just not an option to not see my clients,” she said Tuesday.
Channel 13 reached out to Gov. Joe Lombardo’s office, and a spokesperson told us they’re aware of Retic’s situation. They also say they’re committed to ensuring a smooth process for providers working to get Medicaid contracts revalidated.
Additionally, NVHA continues to share this information with providers:
Currently, Nevada Medicaid’s average processing time for these applications is 25 days; this includes from the date of a complete submission to the date of a decision for approval or denial by the state. If a provider sends an application that needs correcting, the average return time by the state to the provider to request additional information is 1.3 days. While we understand this may not be the experience of every provider, we do believe that the process has improved significantly in the last year with the rollout of our new online modernized process for completing revalidation applications—Provider Flex.
As always, we strive to improve the experience of our providers at Nevada Medicaid. To ensure a smooth process for revalidation, Nevada Medicaid strongly recommends that providers submit their completed applications at least 90 days before their revalidation deadline. This allows time for state processing, third-party verification, and resolution of any issues without risking a gap in the provider’s enrollment. Providers experiencing challenges with the revalidation process or the online application can reach out directly to Nevada Medicaid at ProviderEnrollment@nvha.nv.gov.
