Who should I call if I have any questions about filing a complaint?

You can contact the Nevada Division of Insurance at (775) 687-0700 (Carson City office), (702) 486-4009 (Las Vegas office) or toll-free at (888) 872-3234. The Department is open from 8:00 a.m. to 5:00 p.m. Monday through Friday.

What happens after the Department receives my complaint?

Your health insurer should respond to your complaint within 28 calendar days. If you have not heard from the Division within 30 days, you should contact the Division to follow up.[16] The Department will investigate your claim and can require the...

How do I file a complaint?

If you are a Nevada resident and you think your insurer has done something illegal or unethical, you can file a complaint with the Nevada Division of Insurance (“Division”). Complaint information. You can find a copy of the complaint form here. Your...

How long will the external review process take?

The external review process should take no longer than 15 days.[10] If you request an expedited external review, the Office for Consumer Health Assistance will let you know within 72 hours whether your claim is eligible for an expedited review.[11] If your...

How do I request an external review?

You should send your request for an external review to the Governor’s Office for Consumer Health Assistance (“Governor’s Office”) within four months from when your insurer sent you the final decision.[4] The Governor’s Office will then assign an external review organization...

In what circumstances can I apply for an external review?

During an external review, an independent third party reviews your insurer’s decision.[3] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. You are entitled to an external review if your insurer...

How long should the internal appeals process take?

The internal appeals process should take a maximum of 30 days unless you and your insurance company agree to a longer time period.[2]

How do I request an internal appeal?

If your insurer denies your claim, you have the right to an internal appeal.[1] This means you can ask your insurer to conduct a full and fair review of its decision. To appeal the denial, you should do the following: Review...

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