MedicaidAdministrativeMedium impact
Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for June 2025 Professional Claims
Nevada Medicaid·NV·Billing & Coding
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has published the top 10 claim denial reasons for June 2025, providing specific error codes and step-by-step resolutions for common billing issues. This guidance helps billing teams understand why claims are being denied and provides actionable workarounds to resolve these denials.
Action Required
Immediately: Billing team should review the top 10 denial codes (452, 2003, 2017, 4021, 1009, 3001, 5035, 3340, 676, 4371) and implement the specified resolution steps. Update billing workflows to verify patient eligibility, prior authorizations, and provider contracts before claim submission. Train staff on using the Provider Web Portal for eligibility verification and claim adjustments. Monitor remittance advices for these specific EOB codes and follow the documented resolution steps to reduce future denials.