Member Rights

As a consumer of Nevada Health Solutions utilization management services through your health plan, you have rights and responsibilities.

Your rights:

  • To be treated with respect and dignity by our staff
  • To get care without regard to sex, race, health status, color, age, national origin, sexual orientation, marital status or religion
  • To receive medically necessary care
  • To have your medical records and information about your care be treated as private and protected according to law
  • To get information in a language you understand; you can get oral translation services free of charge
  • To appoint someone to speak for you about your care and treatment
  • To have our staff inform you and answer your questions about the preauthorization process
  • To be informed about the clinical tools used to approve or deny treatment plan requests when you ask our staff
  • To get information on available treatment options and alternative presented in a manner and language that you understand
  • To be instructed how to file a complaint if you have concerns
  • To be instructed on how to file an appeal with your health plan

 

Your responsibilies:

  • To provide complete and correct information about your medical condition
  • To treat our staff with respect
  • To understand the services and benefits covered by your health plan
  • To know when you should or should not go to the emergency room
  • To use providers who work with your health plan
  • To protect your member ID card and show it when you get service
  • To tell your health plan about any other insurance that you have
  • To file a complaint when you have concerns with our services