Section 439B.Sec. 18 - NEW1. Except as otherwise provided in subsection 2, a data submitter that submits historical data relating to covered medical services, dental services or pharmacy services shall include information on all service lines for every claim paid or encounter processed during the reporting period for which the historical data is submitted, regardless of the location where the service was provided.2. Except as otherwise provided in this subsection, a data submitter is not required to submit historical data pursuant to subsection 1 for a claim which is denied in its entirety. A data submitter shall submit historical data for a claim which was paid and reported to the allpayer claims database but is subsequently reversed or denied.3. Files submitted to the all-payer claims database that contain historical data relating to providers of health care must include demographic data and other relevant data relating to each provider of health care who is referenced in historical data described in subsection 1 or 4, including, without limitation: (a) Primary care providers;(f) Prescribing providers; and4. Files containing historical data relating to the eligibility for coverage and demographics of covered persons must include data for each covered person who resided in this State and was eligible for a defined set of benefits for 1 or more days within the reporting period. If a covered person is covered by more than one distinct policy, a record must be included for each policy. If the reporting period of the file spans multiple months, the covered person must be reported with one record per month of eligibility.5. As used in this section, "encounter" means a covered service or group of services delivered by a provider to a covered person during a visit or as a result of a visit between the covered person and the provider.Nev. Admin. Code § 439B.Sec. 18
Added to NAC by Dep't of Human Resources by R104-23A, eff. 11/15/2024