Update Your Provider Information
Failure to correct inaccurate information, or bill utilizing Medicaid enrollment profile data, will result in claim rejections as of January 1, 2021.
Transitioning providers commonly need to update:
- Address including ZIP+4
- Group affiliation
Availity offers health care professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.
With Availity, you can:
Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Prescription Drug Monitoring Program
The Prescription Drug Monitoring Program (PDMP) is a program through which prescriptions are tracked to help identify patient who may be misusing opiods or other controlled substances. All providers who prescribe C-II controlled substances to Medicaid members must review the prescription drug history in the Nebraska PDMP within seven (7) days prior to prescribing the C-II medication. For additional information, please see the PDMP presentation:
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program. The New Baby, New Life program is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
Behavioral Health Provider
We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.
Provider Tools & Resources
- Log In To Availity
- Launch Provider Learning Hub Now
- Learn About Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)
- Quality of Care Form