2021 Nevada Revised Statutes
Chapter 686A - Trade Practices and Frauds; Financing of Premiums
NRS 686A.313 - Required coordination by multiple insurers for certain dental claims; denial of claim prohibited; regulations.
1. The following provisions apply to a claim for payment submitted for services provided by an oral and maxillofacial surgeon which may be covered, in whole or in part, by a stand-alone dental benefit and a policy of health insurance:
(a) If a claimant is covered by a stand-alone dental benefit and a policy of health insurance, the stand-alone dental benefit is the primary policy and the claim must be first submitted to the health insurer that issued the stand-alone dental benefit. The issuer of the secondary policy may not reduce benefits based upon payments under the primary policy, except to avoid overpayment to the oral and maxillofacial surgeon.
(b) Except as otherwise provided in paragraph (a), a health insurer may not deny a claim for which it has liability solely on the basis that another health insurer has liability to pay the claim.
2. The Commissioner may adopt regulations necessary to carry out the provisions of this section.
3. As used in this section:
(a) "Oral and maxillofacial surgeon" means a dentist who has been issued a specialist’s license to practice oral and maxillofacial surgery pursuant to NRS 631.250 and who provides any of the services described in paragraph (c) of subsection 1 of NRS 631.215.
(b) "Stand-alone dental benefit" means any policy which only pays for or reimburses any part of the cost of dental care, as defined in NRS 695D.030, and is offered or issued separately from any policy of health insurance.
(Added to NRS by 2015, 2120)
