{"data":{"id":"us-nv/nrs-687b.820","jurisdiction":"us-nv","citation":"NRS 687B.820","heading":"Procedures for resolution of disputes; exemptions.","body":"1. A health carrier which offers or issues a network plan shall establish procedures for the resolution of administrative, payment or other disputes between a participating provider of health care in the network and the health carrier. Those procedures must include, without limitation, an efficient process by which a participating provider of health care may challenge the denial of a claim by the health carrier. The process must allow for the clear resolution of each challenge within a reasonable time.\n2. The provisions of this section do not apply to the provision of health care services by a managed care organization to:\n(a) Recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Nevada Health Authority; or\n(b) Members of the Public Employees’ Benefits Program.\n3. As used in this section, “managed care organization” has the meaning ascribed to it in NRS 695G.050.","path":["TITLE 57 — INSURANCE","CHAPTER 687B - CONTRACTS OF INSURANCE","NETWORK PLANS"],"source_url":"https://www.leg.state.nv.us/NRS/NRS-687B.html#NRS687BSec820","current_through":"2025 session (NRS as revised 2026-08-25)","vintage":"","retrieved_at":"2026-09-03T05:51:46Z","sha256":"b8b5b825616453a940299d0d43222c9023b4cfcf2a05487b5b7f7ceed45cac2d","source_id":"us-nv","stale":true,"prev":"us-nv/nrs-687b.810","next":"us-nv/nrs-687b.830"},"notice":"GroundRules: Original legal text. Not legal advice."}