Compliance Corner: Nevada Duties of Health Care Providers Required to File Claims

Reno, NV (WorkersCompensation.com) -- In Nevada, health care providers who are required to file claims for compensation must handle some obligations as part of the claim process. Here's a look at what those duties involve.

A health care provider who is required to file a claim for compensation, shall:

+ Require the injured employee to complete the upper portion of the form designated in NAC 616A.480 as Form C-4, Employee’s Claim for Compensation/Report of Initial Treatment, including, without limitation, the name, address and telephone number of the employer of the injured employee and the name of the insurer or third-party administrator of the employer.

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+ Contact the employer or the insurer or third-party administrator of the employer to confirm the name and address of the insurer or third-party administrator.

+ Send a copy of the completed Form C-4 to the employer and to the insurer or third-party administrator of the employer.

+ Maintain, together with the completed Form C-4, documentation of the steps taken by the health care provider to verify that the insurer or third-party administrator is the insurer or third-party administrator of the employer.

If the health care provider is unable to confirm whether an insurer or third-party administrator is the insurer or third-party administrator of the employer within three working days after first providing treatment to an injured employee for a particular injury, the health care provider shall:

+ Contact the nearest office of the Division by telephone at (702) 486-9000 for Las Vegas, Nevada, or at (775) 684-7260 for Carson City, Nevada; and

+ If requested by the Division, provide a copy of the completed Form C-4 and documentation of the steps taken to verify that the insurer or third-party administrator is the insurer or third-party administrator of the employer.

Under Nevada law, “health care provider” means a physician, chiropractic physician, physician assistant or advanced practice registered nurse.

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