NRS 687B.697 - Access to services and contractual discounts of a provider of health care: Obligations of health carrier and third parties concerning remittance advice or explanation of payment; requirements of third party. [Effective January 1, 2020.]

NV Rev Stat § 687B.697 (2019) (N/A)

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1. A health carrier and third parties are obligated to comply with NRS 687B.694 and 687B.696 concerning the services referenced on a remittance advice or explanation of payment. A provider of health care may refuse the discount taken on the remittance advice or explanation of payment if the discount is taken without a contractual basis or in violation of NRS 687B.693 or 687B.695. An error in the remittance advice or explanation of payment may be corrected not more than 30 days after given notice of the error by the provider of health care.

2. A health carrier may not lease, rent or otherwise grant to a third party, access to a provider network contract unless the third party accessing the provider network contract is:

(a) A payer or third party, administrator or other entity that administers or processes claims on behalf of the payer;

(b) A preferred provider of health care organization or preferred provider of health care network, including a physician organization or a physician-hospital organization; or

(c) An entity engaged in the electronic claims transport between the health carrier and the payer that does not provide access to the services and discounts of a provider of health care to any other third party.

(Added to NRS by 2019, 1605, effective January 1, 2020)

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NRS 687B.696 - Access to services and contractual discounts of a provider of health care: Information required to be provided by third parties. [Effective January 1, 2020.]

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NRS 687B.700 - Participating provider of health care to continue delivery of services if health carrier or intermediary insolvent or ceases operations; billing of covered person; termination of services.