Grievances and appeals in Nevada

Let us know if we missed the mark

You may want to file a grievance if:

• You're not satisfied with Anthem Medicaid in Nevada for any reason.
• You've had a problem with the quality of care you've received from our services or network providers.
• You've had difficulty getting access to care.
• You feel your rights and dignity have been disrespected.
• You have experienced rude behavior from a provider or an Anthem Medicaid associate.

To appoint a representative to act on your behalf, please provide your written consent. Your representative can be a friend or family member, your doctor, or an attorney.

Directly submit a grievance by logging into the secure member portal or the Sydney Health mobile app. You can find Grievances under the Support tab.

You can appeal within 60 days if your service gets denied

If we deny, reduce, or end treatment or services, we'll send you a Notice of Adverse Determination. It will:

• Explain why we won't pay for the care or services requested by your provider.
• Tell you about your right to appeal our decision.

You, or your approved representative, can appeal the decision.

Directly submit an appeal by logging into the secure member portal or the Sydney Health mobile app. You can find Appeals under the Support tab.

Request for Appeal Forms

If you'd like to appeal in writing, please use one of the forms below:

Request for Appeal Form (English) -- PDF coming soon

Request for Appeal Form (Spanish) -- PDF coming soon

Authorized Representative for Managed Care Appeals (English) -- PDF coming soon

Authorized Representative for Managed Care Appeals (Spanish) -- PDF coming soon

Have questions?

Check your member handbook or live chat with a representative in the Sydney Health app.

Download Sydney Health