NRS 695D.215
Claims: Approval or denial

  • request for additional information
  • payment
  • interest on unpaid claim.

1.

Except as otherwise provided in subsection 2, an organization for dental care shall approve or deny a claim relating to a plan for dental care within 30 days after the organization for dental care receives the claim. If the claim is approved, the organization for dental care shall pay the claim within 30 days after it is approved. If the approved claim is not paid within that period, the organization for dental care shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040. The interest must be calculated from the date the payment is due until the claim is paid.

2.

If the organization for dental care requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim. The organization for dental care shall notify the provider of dental care of the reason for the delay in approving or denying the claim. The organization for dental care shall approve or deny the claim within 30 days after receiving the additional information. If the claim is approved, the organization for dental care shall pay the claim within 30 days after it receives the additional information. If the approved claim is not paid within that period, the organization for dental care shall pay interest on the claim in the manner prescribed in subsection 1.

Source: Section 695D.215 — Claims: Approval or denial; request for additional information; payment; interest on unpaid claim., https://www.­leg.­state.­nv.­us/NRS/NRS-695D.­html#NRS695DSec215.

695D.010
Definitions. 695D.020
“Commissioner” defined. 695D.030
“Dental care” defined. 695D.040
“Dentist” defined. 695D.050
“Member” defined. 695D.060
“Organization for dental care” defined. 695D.070
“Plan for dental care” defined. 695D.080
“Policy” defined. 695D.090
Applicability. 695D.095
Applicability of other provisions to organizations for dental care. 695D.100
Regulations of Commissioner. 695D.102
Summary of coverage: Contents of disclosure 695D.104
Summary of coverage: Copy to be provided before policy issued 695D.110
Certificate of authority: Required for plan for dental care. 695D.120
Certificate of authority: Application. 695D.130
Certificate of authority: Issuance. 695D.140
Certificate of authority: Notice of change of information 695D.150
Certificate of authority: Expiration 695D.153
Capital account: Minimum amount 695D.157
Hazardous financial condition: Regulations 695D.160
Composition of board of directors for organization for dental care. 695D.170
Bond or deposit required 695D.180
Bond payable to State 695D.190
Fiduciary responsibilities 695D.200
Policy: Issuance 695D.203
Group plan issued to replace discontinued policy or coverage: Requirements 695D.205
Copayments and deductibles. 695D.210
Coverage for newly born and adopted children and children placed for adoption. 695D.215
Claims: Approval or denial 695D.216
Required provision concerning coverage for services provided through telehealth. 695D.217
Organization for dental care prohibited from denying coverage solely because person was victim of domestic violence. 695D.219
Organization for dental care prohibited from denying coverage solely because member was intoxicated or under the influence of controlled substance 695D.220
Licensing of agents. 695D.225
Contracts between organization for dental care and dentist: Modification 695D.227
Prohibition of setting of fees by plan or organization for dental care other than covered services to members. 695D.230
Approval of advertising or materials used to solicit members. 695D.240
Limitation on expenses for marketing and administration. 695D.250
Reserves 695D.260
Annual report, financial statement and tax 695D.270
Examination of organization by Commissioner. 695D.280
Rehabilitation, liquidation or conservation. 695D.290
Trade practices and frauds. 695D.300
Disciplinary actions 695D.310
Notice of disciplinary action
Last Updated

Feb. 5, 2021

§ 695D.215’s source at nv​.us