Nevada Revised Statutes 695C.1795 – Reimbursement to provider of medical transportation
1. Except as otherwise provided in subsection 3, every evidence of coverage amended, delivered or issued for delivery in this State after October 1, 1989, that provides coverage for medical transportation, must contain a provision for the direct reimbursement of a provider of medical transportation for covered services if that provider does not receive reimbursement from any other source.
Terms Used In Nevada Revised Statutes 695C.1795
- Enrollee: means a natural person who has been voluntarily enrolled in a health care plan. See Nevada Revised Statutes 695C.030
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Health maintenance organization: means any person which provides or arranges for provision of a health care service or services and is responsible for the availability and accessibility of such service or services to its enrollees, which services are paid for or on behalf of the enrollees on a periodic prepaid basis without regard to the dates health services are rendered and without regard to the extent of services actually furnished to the enrollees, except that supplementing the fixed prepayments by nominal additional payments for services in accordance with regulations adopted by the Commissioner shall not be deemed to render the arrangement not to be on a prepaid basis. See Nevada Revised Statutes 695C.030
- Provider: means any physician, hospital or other person who is licensed or otherwise authorized in this state to furnish health care services. See Nevada Revised Statutes 695C.030
2. The enrollee or the provider may submit the claim for reimbursement. The provider shall not demand payment from the enrollee until after that reimbursement has been granted or denied.
3. Subsection 1 does not apply to any agreement between a health maintenance organization and a provider of medical transportation for the direct payment by the organization for the provider’s services.