2022 Nevada Revised Statutes
Chapter 687B - Contracts of Insurance
NRS 687B.725 - Claim for dental care: Requirements and limitations related to recovery of overpayments.
1. A health carrier which provides dental coverage or any administrator of a health benefit plan that includes dental coverage who recovers overpayments shall provide written notice to a dentist of any attempt to recover the overpayment, other than a duplicate payment. The notice must include, without limitation:
(a) A description of the error that justifies the recovery; and
(b) The date on which the dental care for which the overpayment was made was provided and the name of the patient to whom the dental care was provided.
2. A health carrier who provides dental coverage or an administrator who recovers overpayments under a health benefit plan that includes dental coverage shall establish written procedures by which a dentist may challenge an attempt to recover an overpayment. Those procedures must include, without limitation, procedures for sharing information concerning a disputed claim with the dentist.
3. Except as otherwise provided in this subsection, a health carrier who provides dental coverage or an administrator who recovers overpayments under a health benefit plan that includes dental coverage shall not attempt to recover an overpayment more than 12 months after the date of the overpayment. This subsection does not apply to an attempt to recover an overpayment that is:
(a) Based on a reasonable belief that the overpayment involved fraud, abuse or other intentional misconduct;
(b) Initiated by or at the request of a self-insured employer; or
(c) Based on dental care that is covered by the Public Employees’ Benefits Program or a system of health insurance for the benefit of local officers and employees, and the dependents of local officers and employees, pursuant to chapter 287 of NRS.
4. Any provision of a contract that conflicts with this section is against public policy, void and unenforceable.
(Added to NRS by 2021, 3525)
