Submit or Appeal a Claim

File a claim. 

Send a claim form and an itemized bill to:

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

The itemized bill should include:

  • Name, address and tax ID number 
  • Date of service 
  • Diagnosis 
  • Description of services and/or standardized codes rendered, and itemized charges for each service

Appeal a claim.

Complete a claim reconsideration form. Mail the form, a description of the claim and pertinent documentation to:

Health Plan of Nevada
Attn: Claims Research
PO Box 15645
Las Vegas, NV 89114-5645

To prevent processing delays, be sure to include the member’s name and his/her member ID along with the provider’s name, address and TIN on the form.

To request an adjustment for a claim that doesn’t require written documentation, call Member Services at 1-800-777-1840.

If you have a request involving 20 or more paid or denied claims, please fill out a claims project spreadsheet (Excel) and submit necessary documentation via secure email to pri@sierrahealth.com.

At a minimum, please include the following information:

  • Member’s first and last name
  • Member’s date of birth 
  • Member’s health plan ID number 
  • Claim number 
  • Line of business 
  • Explanation of issue 
  • Expected outcome

Please allow 30 days from date of receipt for all claim reconsiderations. For facility appeal instructions, click here.

Need further assistance? Review our claims reconsideration quick reference guide.