Nevada § 695G.307 Health carrier required to provide description of external review procedures; format; contents

Nevada Statutes

§ 695G.307 — Health carrier required to provide description of external review procedures; format; contents

Nevada § 695G.307

Title 57INSURANCE

Ch. 695GManaged

EXTERNAL REVIEW OF ADVERSE DETERMINATION

This text of Nevada § 695G.307 (Health carrier required to provide description of external review procedures; format; contents) is published on Counsel Stack Legal Research, covering Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Nev. Rev. Stat. § 695G.307 (2026).

Text

1.A health carrier shall include a description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage or other evidence of coverage it provides to covered persons.

2.The description required by subsection 1 must be in a format prescribed by the Commissioner.

3.The description required by subsection 1 must include a statement that informs the covered person of the right of the covered person to file a request for an external review of an adverse determination with the Office for Consumer Health Assistance. The statement may explain that external review is available when the adverse determination involves an issue of medical necessity, appropriateness, health care setting, level of care or effectiveness. The statement must incl

Free access — add to your briefcase to read the full text and ask questions with AI

1. A health carrier shall include a description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage or other evidence of coverage it provides to covered persons.
2. The description required by subsection 1 must be in a format prescribed by the Commissioner.
3. The description required by subsection 1 must include a statement that informs the covered person of the right of the covered person to file a request for an external review of an adverse determination with the Office for Consumer Health Assistance. The statement may explain that external review is available when the adverse determination involves an issue of medical necessity, appropriateness, health care setting, level of care or effectiveness. The statement must include the telephone number and address of the Office for Consumer Health Assistance.
4. In addition to the requirements of subsection 3, the statement must inform the covered person that, when filing a request for an external review, the covered person will be required to authorize the release of any medical records of the covered person that may be required to be reviewed for the purpose of reaching a decision on the external review.