695G.080 - “Utilization review” defined. - Nevada Statutes

695G.080  “Utilization review” defined.

      1.  “Utilization review” means the various methods that may be used by a managed care organization to review the amount and appropriateness of the provision of a specific health care service to an insured.

      2.  The term does not include an external review of a final adverse determination conducted pursuant to NRS 695G.241 to 695G.310, inclusive.

      (Added to NRS by 1997, 302; A 2003, 783)