Nev. Admin. Code § 616B.707 - Consideration of expenditures as expenditures for claims; computation and reporting of value of clinical services
1. The Division
will consider expenditures for the following as expenditures for claims:
(a) A surgeon, assisting surgeon,
anesthesiologist or consulting physician.
(b) Charges by a hospital.
(c) Treatment by a physician or
chiropractor.
(d) X-ray films,
computerized axial tomography (CAT) scans, myelograms, magnetic resonance
imaging, and other diagnostic tests and procedures.
(e) Physical therapy.
(f) Prescribed drugs and medications,
eyeglasses, dental work, prostheses, orthotic devices and corrective shoes by
prescription.
(g) Travel to obtain
medical care or supplies.
(h) Any
other accident benefits.
(i)
Compensation for a permanent total, temporary total, permanent partial or
temporary partial disability.
(j)
Costs of vocational rehabilitation services for an injured employee.
(k) Death benefits.
(l) Burial expenses.
2. The Division will not consider the
following expenditures to be expenditures for claims:
(a) Amounts held in reserve for any
anticipated expense in connection with a claim.
(b) Money paid in excess of the compensation
calculated pursuant to
NRS
616C.440,
616C.475,
616C.490 or
616C.500 or NAC
616C.577 for a temporary total,
temporary partial, permanent total or permanent partial disability or
vocational rehabilitation maintenance.
(c) Legal expenses, including, without
limitation, court costs, attorney's fees, costs for depositions, investigations
and hearings.
(d) Payment of an
award of interest.
(e) Payment of
claims in connection with the Uninsured Employers' Claim Account.
(f) Administrative expenses, including,
without limitation, expenses incurred for:
(1)
Copying records;
(2) Reviewing any
report of a physician or chiropractor contained in a file relating to a claim;
or
(3) Services relating to the
management of costs of medical care.
(g) Costs incurred in a claim that is
ultimately denied.
3.
The value of clinical services furnished by an insurer for industrial injuries
or illnesses must be computed and reported pursuant to the schedule of fees and
charges for accident benefits adopted pursuant to subsection 2 of
NRS
616C.260.
Notes
NRS 232.680, 616A.400
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