# NV Bulletin 00-004: Balance Billing by Contracted Providers > Nevada · Agency guidance · In force URL: https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_004 ## Section - **Citation:** NV Bulletin 00-004 - **Heading:** Balance Billing by Contracted Providers - **Jurisdiction:** Nevada - **Kind:** Agency guidance - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Nevada Division of Insurance Bulletins / Balance Billing by Contracted Providers ## Text Bulletin 00-004 ## BALANCE BILLING BY CONTRACTED PROVIDERS December 15, 2000 The Department of Business and Industry, Division of Insurance (Division), has learned that some providers of healthcare who have executed preferred provider contracts are billing insured patients for amounts greater than the agreed upon discounted contract rate. This practice is known as "balance billing." Some insured patients have paid amounts greater than those specified in the contractual discount arrangement. To knowingly and willingly file a claim for an amount that is not due and is greater than the contracted rate is a violation of the false claims section of the Unfair Trade Practices and Fraud Act, specifically NRS 686A.291. Discounted charges agreed upon by a preferred provider of healthcare and a payor must be similarly limited to the amounts owed by the insured. Each contract between a payor and a provider of healthcare that establishes reduced rates must state that the contracted rate is the total amount due for the covered service and that the insured is not responsible for amounts above the contracted rate. Any Explanation of Benefits (EOB), Explanation of Payment (EOP), or similar form of each insurer must clearly disclose that the insured is not responsible for amounts greater than the contracted amount. The insured must be informed that providers are not to balance bill the difference between the billed amount and the contracted amount. The notice on the Explanation of Benefits and Explanation of Payment must include language substantially as follows: "The billed charges exceed the contracted amounts agreed to by this provider for the covered service. Because this provider is a preferred contracted provider for your plan, you are not responsible for the difference between the billed charges and the contracted charges. This provider is prohibited from billing you for the difference." Alice A. Molasky-Arman COMMISSIONER OF INSURANCE B-189 Added, 2001-1 © 2001, NILS Publishing Company 4/2001 greed to by this provider for the covered service. Because this provider is a preferred contracted provider for your plan, you are not responsible for the difference between the billed charges and the contracted charges. This provider is prohibited from billing you for the difference." Alice A. Molasky-Arman COMMISSIONER OF INSURANCE B-189 Added, 2001-1 © 2001, NILS Publishing Company 4/2001 ASSEMBLY COMMERCE & LABOR 1004 DATE: 2/17/03 ROOM: 4100 EXHIBIT E SUBMITTED BY: Alice Molasky-Arman ## Nearby sections - [NV Bulletin 00-001 Workers' Compensation Appeals Panel](https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_001.md) - [NV Bulletin 00-002 Workers' Compensation Issues](https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_002.md) - [NV Bulletin 00-003 Workers' Compensation Deductible Programs](https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_003.md) - [NV Bulletin 00-004 Balance Billing by Contracted Providers](https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_004.md) - [NV Bulletin 01-002 Unlawful Rebates in the Sale of Life or Health Insurance](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_002.md) - [NV Bulletin 01-003 Groups Formed for the Purpose of Procuring Insurance](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_003.md) - [NV Bulletin 01-004 Credit Insurance](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_004.md) - [NV Bulletin 01-005 Marketing of Group Life and Health Insurance](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_005.md) - [NV Bulletin 01-006 Life Insurance Policies with No Benefit for the First Two Years](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_006.md) - [NV Bulletin 01-007 Accounting for Health Care Receivables Reporting Receivables on the Quarterly Statements](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_007.md) - [NV Bulletin 01-009 Violent Crime Control and Law Enforcement Act of 1994](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_009.md) - [NV Bulletin 01-010 Executive Order Blocking Property and Prohibiting Transactions with Persons who Permit, Threaten to Commit, or Support Terrorism](https://www.frixlaw.com/law-library/statutes/NV_INS_B_01_010.md) - [NV Bulletin 02-000 Voluntary Expedited Filing Procedures for Compliance with the Provision of the Terrorism Risk Insurance Act of 2002](https://www.frixlaw.com/law-library/statutes/NV_INS_B_02_000.md) - [NV Bulletin 02-001 Risk Base Capital Instructions Pursuant to NAC 681B.430](https://www.frixlaw.com/law-library/statutes/NV_INS_B_02_001.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/NV_INS_B_00_004. Check the current official text before relying on it. Not legal advice.