External review in Nevada: deadline, cost and how to ask
Nevada runs its own independent review of denials: External Review (Office for Consumer Health Assistance). You generally have 4 months to ask for it.
External review means a doctor or reviewer outside your plan decides again. Internal appeal means your plan looks at its own decision again.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Step 2: Outside review in Nevada
- Program
External Review (Office for Consumer Health Assistance)
- Who runs it
- Office for Consumer Health Assistance (OCHA), which assigns an independent review organization on a rotating basis: Health carriers regulated by Nevada (insurance policies and managed care plans). Not for Medicare, Medicaid, FEHBP, TRICARE, workers' compensation or limited-benefit policies.
- Deadline to ask
Federal rule: at least 4 months.
Send your request to OCHA within 4 months after you receive the denial notice. The same 4 months applies to denials of experimental or investigational treatment.
- The deadline runs from
The date you receive the notice of the adverse determination
- Do I have to appeal to my plan first?
Usually you must finish your plan's internal appeal first. If the plan has not given you a written decision within 30 days after you filed your grievance (and you did not agree to a delay), you can go to external review and are treated as having finished the internal process. Expedited external review can be asked for at the same time as an expedited grievance in urgent cases.
- When you can go without a plan answer
30 days after you file your internal appeal
- How long the review takes
Standard: 15 days; Urgent: 48 hours
- Cost
Free to you. The health carrier that made the denial pays the cost of the external review.
- What can be reviewed
Denials that involve a judgment about medical necessity, appropriateness, health care setting, level of care or effectiveness, and denials of treatment as experimental or investigational. Grievances that do not involve these are not external review cases.
- Is the decision final?
If the independent reviewer decides in your favor, the decision is final, conclusive and binding on the health carrier.
- How to ask
Fill out the OCHA External Review Request Form, sign the medical records release, and send it to OCHA by mail, fax or email. Attach a copy of your insurance card and the plan's letter saying its decision is final (or that the internal review was waived). For expedited review, attach the Healthcare Provider Certification Form from your doctor. You can also start with OCHA's online Request for Assistance form.
Law: NRS 695G.241-695G.310 (esp. 695G.245, 695G.247, 695G.251, 695G.261, 695G.271, 695G.275, 695G.290)
- Forms and online request
- Phone
1-888-333-1597 or 725-281-3122; fax 702-486-3586; email cha@govcha.nv.gov
Write my appeal: free letters
Sources
The official sources for Nevada are listed on the Nevada page.