NAC695C.235. System for resolving complaints of enrollees of health maintenance organizations: Annual report.

     1. A health maintenance organization shall submit its annual report regarding its system for resolving complaints as required pursuant to NRS 695C.260 and 695G.220 on or before June 1 of each year. The health maintenance organization shall retain a copy of the annual report for at least 3 years or until the next examination conducted by the Division, whichever is longer.

     2. The health maintenance organization is not required to include in the annual report information concerning an oral inquiry by an enrollee relating to a misunderstanding or miscommunication if the misunderstanding or miscommunication was resolved within 1 working day after the inquiry was made. If the misunderstanding or miscommunication was not resolved within 1 working day, the health maintenance organization shall report it as a complaint in the annual report.

     (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99; A by R148-99, 1-27-2000; R008-02, 5-23-2002)