Ê×Ò³| Â鶹´«Ã½Ó³»­

As a member of the , you have the right to voice complaints about the plan or submit appeals. You have the right to ask the Plan Administrator or its designees to reconsider a determination resulting in a denial (in whole or in part) for a service or treatment, or rescission of coverage (retroactive cancellation). you have the right to be provided the opportunity to voice complaints or appeals about the plan and /or the care provided.

You can call Member Services toll-free at 1-877-545-7378, TTY 711 with questions about your Health Plan of Nevada HMO plan. Business hours are Monday through Friday from 8 a.m. to 5 p.m. You can also access your plan information through the online member center. Create an account or sign in at . Once you create an account, you can view your benefit information, claims history, pharmacy information, and more.

Member Services can review your claims data, send it back for reprocessing, and request additional information from your provider, if needed. All correspondence is documented and every call to Member Services is recorded in order to track accuracy.

If a benefit is denied, Health Plan of Nevada provides an internal review by contacting the Member Services at 1-877-545-7378, TTY 711. Additionally, external independent review is provided by a panel of impartial medical professionals for eligible denials which have already undergone internal review. Expedited appeals are available when decisions are needed quickly.

As a member of Health Plan of Nevada, you have 180 days from the date of the denial to file an appeal. You or your provider may submit a request or initiate an appeal for the informal review of a decision by calling Member Services at 1-877-545-7378, TTY 711 or mailing a written request to:

Appeals and Grievances Department
Health Plan of Nevada
P.O. Box 15645 Las Vegas, NV 89114-5645