ABA providers should submit this form for Applied Behavioral Analysis (ABA) therapy authorization requests.
Complete this form for Behavioral Health Outpatient Treatment authorization requests.
Submit an Oncology Step Therapy Exception form for members with stage 3 or stage 4 cancer. Oncology requests should be submitted under urgent status through phone, fax or web portal.
The goal is to ensure health plan members receive the most appropriate, medically necessary care. All requests are reviewed by a licensed physician or under the supervision of one. Furthermore, only a physician may deny a request.
You may file an appeal if coverage is denied.
To appeal a decision, mail a written request to:
Health Plan of Nevada, Member Services
P.O. Box 15645
Las Vegas, NV 89114-5645
Health Plan of Nevada providers must file an appeal within 180 days.