1. Each prepaid limited health service organization shall establish a system for the resolution of written complaints submitted by enrollees and providers.
2. The provisions of subsection 1 do not prohibit an enrollee or provider from filing a complaint with the Commissioner or limit the Commissioner’s authority to investigate such a complaint.
3. Each prepaid limited health service organization that issues any evidence of coverage that provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care shall provide a system for resolving any complaints of an enrollee or subscriber concerning those health care services that complies with the provisions of NRS 695G.200 to 695G.310, inclusive.
(Added to NRS by 1991, 1117; A 2003, 779; 2011, 3397)
Structure Nevada Revised Statutes
Chapter 695F - Prepaid Limited Health Service Organizations
NRS 695F.020 - "Enrollee" defined.
NRS 695F.030 - "Evidence of coverage" defined.
NRS 695F.040 - "Limited health service" defined.
NRS 695F.043 - "Medicaid" defined.
NRS 695F.047 - "Order for medical coverage" defined.
NRS 695F.050 - "Prepaid limited health service organization" defined.
NRS 695F.060 - "Provider" defined.
NRS 695F.070 - "Subscriber" defined.
NRS 695F.080 - General applicability of title 57 of NRS.
NRS 695F.090 - Applicability of chapter and other provisions.
NRS 695F.100 - Certificate required.
NRS 695F.110 - Application; fee.
NRS 695F.120 - Review of application; issuance of certificate.
NRS 695F.140 - Denial of application; hearing.
NRS 695F.150 - Evidence of coverage: Issuance; contents; amendment.
NRS 695F.160 - Rates and charges: Reasonableness.
NRS 695F.190 - Requirements for reserve.
NRS 695F.210 - Maintenance of fidelity bond or deposit in lieu of bond.
NRS 695F.212 - Hazardous financial condition: Regulations; determination; powers of Commissioner.
NRS 695F.230 - Establishment of system for resolution of complaints.
NRS 695F.310 - Examinations and investigations.
NRS 695F.330 - Payment of premium tax.
NRS 695F.360 - Violations of chapter: Order to cease and desist; fine.
NRS 695F.410 - Confidentiality and disclosure of information.