Expert Revenue Cycle Management in Nevada
Mediknocx runs the full revenue cycle for Nevada physician practices, from eligibility checks to the final payment on an appealed claim. Our workflows are built for Anthem Blue Cross and Blue Shield and Health Plan of Nevada (HPN), and for a Nevada Medicaid program that moved to statewide managed care on January 1, 2026.
HIPAA Compliant
Your data stays secure
Faster Payments & Fewer Denials
Improve cash flow
Higher Reimbursement
Get the revenue you deserve
Nevada Billing Compliance Experts
State-specific payer knowledge
Get Your Free Revenue Assessment
Find out how much revenue your practice could be recovering with expert revenue cycle management support. No obligation, just real insights.
Expert Revenue Cycle Management in Nevada: Medicaid Managed Care Goes Statewide
Until 2026, Nevada Medicaid managed care covered only urban Clark and Washoe counties. On January 1, 2026, it expanded to every county, moving about 75,000 rural members from fee-for-service into managed care. Five plans now operate: Anthem, HPN, SilverSummit, Molina, and CareSource. HPN also left Washoe County, so members there were reassigned.
For your revenue cycle, a rural claim that used to go to Nevada Medicaid now goes to whichever plan the member was assigned, under that plan's authorization and filing rules. About 126,000 Nevadans stay in fee-for-service, including seniors, people with disabilities, and waiver participants. Nevada Medicaid shows eligibility one month at a time, so a practice billing both groups has to confirm the payer before every visit.
Expertise
Built for local care models
Deadline Tracking
We flag at-risk claims early
Fewer Denials
Correct coding, less revenue loss
The Full Revenue Cycle We Manage in Nevada
- Patient Access & Eligibility Verification: Monthly Medicaid eligibility, MCO assignment, and commercial benefits confirmed before each visit.
- Charge Capture & Coding: CPT, ICD-10, and modifiers matched to the chart.
- Claims Submission: Clean claims routed to the right MCO, fee-for-service Medicaid, or commercial payer.
- Payment Posting: ERAs posted line by line, with underpayments and out-of-network emergency offers flagged.
- Denial Management & Appeals: Denials sorted by cause, corrected, and appealed on each payer's timeline.
- AR Follow-Up: Open claims worked by payer and age, starting with those closest to a filing limit.
- Reporting: Monthly reports on collections, denial trends, and days in AR.
How It Works
From Audit toFaster Payments in 4 Steps
A simple, proven process to streamline your revenue cycle and maximize reimbursements in Nevada.
Free Audit
We review your recent Nevada claims, denials, and aging AR.
Custom Plan
A written plan covering your payer mix, staff handoffs, and timeline.
Seamless Transition
We connect to your practice management system with no gap in submissions.
Ongoing Reporting
Monthly reports on collections, denial rates, and AR aging, reviewed with your account manager.
Get Your FreeRevenue Cycle Audit Report
Still sorting out which Medicaid plan covers your rural patients? Call +1 434-201-9720 or email info@mediknocx.com for a free revenue cycle audit.
What Makes Our Nevada
Revenue Cycle Management Different
Here's how our Nevada RCM work goes beyond submitting claims.
Single Accountable Team
Eligibility, coding, submission, posting, and appeals sit with one team, so a stalled claim has a clear owner. You call one account manager instead of chasing separate billing and follow-up vendors.
Five-Plan Medicaid Routing
Anthem, HPN, SilverSummit, Molina, and CareSource each run their own authorizations and filing windows. We match every Medicaid claim to the assigned plan and track it against that plan's deadline.
Anthem and HPN Rule Sets
Two of Nevada's largest carriers each write their own prior authorization lists and claim edits. We build both into your pre-submission checks, so avoidable denials are caught before a claim leaves the office.
Payment Clock Tracking
Under Assembly Bill 52, most Nevada commercial claims must be decided and paid within 21 days electronically. We flag late payments so you can pursue the interest and escalation the law allows.
Monthly Performance Reviews
Each month you receive collections, denial rates by payer, and AR aging. Your account manager walks through the report and points out which payers, codes, or locations moved the numbers.
Coverage Across 47 Specialties
Our billers and coders cover 47 specialties, so your claims are handled by people who know that specialty's CPT families, modifier rules, and the documentation Nevada payers request on appeal.
RCM Support for All 47 Specialties in Nevada
Mediknocx manages revenue cycles for 47 medical specialties, from family practice to cardiology and pain management, with billers assigned by specialty.
How Does Mediknocx Ensure Compliance
With Nevada Medical Billing Regulations?
No Surprises Act
We apply federal balance billing and good faith estimate rules alongside Nevada's own emergency out-of-network law (NRS 439B.700 to 439B.760), which limits patients to in-network cost sharing for emergency care.
Nevada Timely Filing and Prompt Pay Law
Fee-for-service Nevada Medicaid requires claims within 180 days of service for in-state providers. Under AB 52 (2025), commercial insurers must approve or deny and pay clean claims within 21 days if submitted electronically, or 30 days on paper, with interest on late payments.
Nevada Patient Collections Rules
Under NRS 649.366, a collection agency must send a 60-day notice before taking any action on medical debt and cannot report it to credit bureaus during that window. We time patient statements with that in mind.
Payer-Specific Guidelines
We follow Anthem, HPN, and Nevada Medicaid MCO policies. Under NRS 439B.754, an out-of-network emergency payment is deemed accepted if you don't respond within 30 days, so we review those offers as they post.
Healthcare Billing Services Across Nevada Cities
We work with practices in Las Vegas, Henderson, and Reno, along with rural clinics newly billing Medicaid managed care plans.
- Las Vegas
- Henderson
- North Las Vegas
- Reno
- Sparks
Nationwide Revenue Cycle Management
Mediknocx also manages revenue cycles for practices in Arizona, Colorado, Texas, Florida, Alabama, Kentucky, Michigan, New Jersey, New Hampshire, and Maryland.
Get paid on Nevada's new timelines, not the old ones. Talk to a Mediknocx revenue cycle specialist at +1 434-201-9720 or info@mediknocx.com and book your free audit.
Frequently Asked Questions
Find answers to the most common questions about our revenue cycle management services in Nevada.
