NJ Admin Code §11:22-1.10(a)(4)
October 15, 2021 5:32 am(4) The health carrier or its agent shall communicate the results of the internal review in a written decision to... View more
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NJ Admin Code §11:22-1.5(a)
October 15, 2021 5:16 am(a) A carrier and its agent shall remit payment of clean claims pursuant to the following time frames: (1) Thirty... View more
NJ Admin Code §11:22-1.6(c)
October 15, 2021 5:23 am(c) If the carrier or its agent fails to pay a clean claim within the time limits set forth in... View more
NJ Admin Code §11:22-1.8(b)
October 15, 2021 5:20 am(b) A health carrier or its agent may request reimbursement for the overpayment of a claim only if the health... View more
NJ Admin Code §11:24-5.2(a)(3)
October 15, 2021 5:31 am(a) The HMO shall provide or arrange for the provision of the following basic comprehensive health services as medically necessary:... View more
NV Rev Stat §689A.717(1-3)
October 15, 2021 5:42 am(1) Except as otherwise provided in this subsection, an individual health benefit plan issued pursuant to this chapter that includes... View more
NV Rev Stat §695C.185(1)
October 15, 2021 5:50 am(1) Except as otherwise provided in subsection 2, a health maintenance organization shall approve or deny a claim relating to... View more
NV Rev Stat §695G.150
October 15, 2021 5:54 amEach managed care organization shall authorize coverage of a health care service that has been recommended for the insured by... View more
NV Rev Stat §695G.170(1-2)
October 15, 2021 5:53 am(1) Each managed care organization shall provide coverage for medically necessary emergency services provided at any hospital. (2) A managed... View more
NV Rev Stat §695G.230(2)
October 15, 2021 5:52 am(2) If a health carrier denies coverage of a health care service to an insured, including, without limitation, a health... View more