NAC695F.630. Annual report: Content; maintenance of records.

     1. Each organization that issues an evidence of coverage in this State shall submit to the Commissioner and the State Board of Health an annual report regarding its system for resolving complaints established pursuant to NAC 695F.600 on a form prescribed by the Commissioner in consultation with the State Board of Health which includes, without limitation:

     (a) A description of the procedures used for resolving any complaints of an enrollee;

     (b) The total number of complaints and appeals handled through the system for resolving complaints since the last report and a compilation of the causes underlying the complaints filed;

     (c) The current status of each complaint and appeal filed; and

     (d) The average amount of time that was needed to resolve a complaint and an appeal, if any.

     2. Each organization shall maintain records of complaints filed with it which concern something other than limited health services and shall submit to the Commissioner a report summarizing such complaints at such times and in such format as the Commissioner may require.

     (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99)