NRS 616C.157
Request for prior authorization: Time to respond

  • effect of failure to respond in timely manner.

1.

An insurer, organization for managed care or third-party administrator shall respond to a written request for prior authorization for:

(a)

Treatment;

(b)

Diagnostic testing; or

(c)

Consultation,
Ê within 5 working days after receiving the written request.

2.

If the insurer, organization for managed care or third-party administrator fails to respond to such a request within 5 working days, authorization shall be deemed to be given. The insurer, organization for managed care or third-party administrator may subsequently deny authorization.

3.

If the insurer, organization for managed care or third-party administrator subsequently denies a request for authorization submitted by a provider of health care for additional visits or treatments, it shall pay for the additional visits or treatments actually provided to the injured employee, up to the number of treatments for which payment is requested by the provider of health care before the denial of authorization is received by the provider.

Source: Section 616C.157 — Request for prior authorization: Time to respond; effect of failure to respond in timely manner., https://www.­leg.­state.­nv.­us/NRS/NRS-616C.­html#NRS616CSec157.

616C.150
Compensation prohibited unless preponderance of evidence establishes that injury arose out of and in course of employment 616C.155
Payment of compensation by insurer prohibited before required 616C.157
Request for prior authorization: Time to respond 616C.160
Newly developed injury or disease: Inclusion in original claim for compensation 616C.165
Determination of responsibility of insurer for undisputed claim for compensation 616C.170
Resolution of disputes between insurers if benefits are claimed against more than one insurer 616C.175
Employment-related aggravation of preexisting condition which is not employment related 616C.177
Medical records concerning preexisting condition: Authority of insurer to request records 616C.180
Injury or disease caused by stress 616C.185
Compensation for mastectomy and reconstructive surgery. 616C.190
Compensation of employee injured out of State. 616C.195
Acceptance of compensation or benefits by employee injured out of State constitutes release of employer and waiver of remedy at common law or statutory remedy provided in another state. 616C.200
Commencement of action in another state to recover damages or compensation by employee injured out of State constitutes irrevocable waiver of compensation due under Nevada law 616C.205
Compensation not assignable 616C.210
Compensation of nonresident alien dependents 616C.215
Actions and proceedings to recover damages in tort or from proceeds of vehicle insurance: Reduction of compensation by amount of recovery 616C.220
Compensation from Uninsured Employers’ Claim Account: Administration and payment of claims 616C.223
Application for entry of summary judgment: Conditions 616C.225
Misrepresentation or concealment of fact to obtain benefits: Insurer entitled to reimbursement or deduction from benefits 616C.230
Grounds for denial, reduction or suspension of compensation 616C.232
Denial of compensation for temporary total disability because of discharge for misconduct. 616C.235
Closure of claim by insurer: Procedure
Last Updated

Feb. 5, 2021

§ 616C.157’s source at nv​.us