As used in NRS 687B.600 to 687B.850, inclusive, unless the context otherwise requires, the words and terms defined in NRS 687B.602 to 687B.665, inclusive, have the meanings ascribed to them in those sections. (Added to NRS by 2017, 2349; A 2019, 298, 1605; 2021, 3527)
“Administrator” has the meaning ascribed to it in NRS 683A.025. (Added to NRS by 2021, 3525)
“Covered person” means a policyholder, subscriber, enrollee or other person participating in a network plan. (Added to NRS by 2017, 2349)
“Dental care” has the meaning ascribed to it in NRS 695D.030. (Added to NRS by 2021, 3525)
“Direct notification” means a written or electronic communication from a health carrier to a provider of health care documenting third-party access to a network. (Added to NRS by 2019, 1602)
“Evidence of coverage” means any certificate, agreement or contract issued to a covered person by a health carrier setting forth the coverage to which the covered person is entitled pursuant to a network plan. (Added to NRS by 2017, 2349)
“Health benefit plan” has the meaning ascribed to it in NRS 695G.019. (Added to NRS by 2017, 2349)
“Health care services” has the meaning ascribed to it in NRS 695G.022. (Added to NRS by 2017, 2349)
“Health carrier” has the meaning ascribed to it in NRS 695G.024. (Added to NRS by 2017, 2349)
“Intermediary” means a person authorized to negotiate and execute a contract between a provider of health care and a health carrier entered into for the purposes of a network plan, whether the person acts on behalf of the provider of health care or the health carrier. (Added to NRS by 2017, 2349)
“Medically necessary” has the meaning ascribed to it in NRS 695G.055. (Added to NRS by 2017, 2349)
“Network” means a defined set of providers of health care who are under contract with a health carrier to provide health care services pursuant to a network plan offered or issued by the health carrier. (Added to NRS by 2017, 2349)
“Network plan” means a health benefit plan offered or issued by a health carrier under which the financing and delivery of health care services, including, without limitation, items and services paid for as health care services, are provided, in whole or in part, through a defined set of providers of health care under contract with […]
“Participating provider of health care” means a provider of health care who, under a contract with a health carrier, has agreed to provide health care services to covered persons pursuant to a network plan with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health carrier. (Added to […]
“Primary care physician” has the meaning ascribed to it in NRS 695G.060. (Added to NRS by 2017, 2350)
“Provider network contract” means a contract between a health carrier and a provider of health care specifying the rights and responsibilities of the health carrier and the provider of health care for delivery of health care services pursuant to a network plan. (Added to NRS by 2019, 1602)
“Provider of health care” has the meaning ascribed to it in NRS 695G.070. (Added to NRS by 2017, 2350)
“Third party” means an organization that enters into a contract with a health carrier or with another third party to gain access to a provider network contract. (Added to NRS by 2019, 1602)
“Utilization review” has the meaning ascribed to it in NRS 695G.080. (Added to NRS by 2017, 2350)
If a health carrier offers or issues a network plan, the health carrier shall, with regard to that network plan: 1. Comply with all applicable requirements set forth in NRS 687B.600 to 687B.850, inclusive; 2. As applicable, ensure that each contract entered into for the purposes of the network plan between a participating provider of […]
