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Provider Name Date of Appeal Form

Provider Name Date of Appeal Form

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welcome to the claim appeals adjustments and voids training for Nevada Medicaid provider in this course we will develop an understanding of the claim appeals process demonstrate how to submit an appeal via secure correspondence and how to adjust or void a claim using the electronic verification system last we will learn where to find additional resources on these subjects the section will demonstrate the claim appeals process and some rules regarding submissions as a Nevada Medicaid provider you have the right to appeal denied claims if you feel that a claim has been denied an error you may request a formal claim appeal by first completing an fa-90 form this form will be discussed in more detail in the following section once the fa-90 form is complete you will need to submit the appeal via secure correspondence in the electronic verification system also called the EVS this appeal must be submitted no later than 30 calendar days past that date shown on the remittance advice once submitt

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