Application for initial issuance of certificate: Generally.

Except as otherwise provided in NAC 683A.610 , an external review organization applying for the initial issuance of a certificate to conduct external reviews must submit to the Commissioner, on a form prescribed by the Commissioner, an application in writing and must provide to the Commissioner at the time of application: 1. A written statement that identifies: (a) The number of external reviewers that the external review organization employs, contracts with or otherwise retains to conduct external reviews; (b) The specialty of each external reviewer; (c) Whether each external reviewer is certified by the entity that regulates his or her specialty; and (d) The schedule of fees that the external review organization will charge to conduct an external review. 2. A written summary of the procedures that the external review organization will use to: (a) Ensure that the external review organization conducts its activities in accordance with NRS 695G.241 to 695G.310 , inclusive; (b) Ensure that an external reviewer employed, contracted with or otherwise retained by the external review organization is qualified to conduct a specific external review; (c) Ensure that a determination submitted for external review is a final adverse determination; (d) Ensure that a final review is conducted in a timely manner in accordance with NRS 695G.251 , 695G.261 and 695G.271 ; (e) Ensure that the external review organization and any employee, agent or contractor of the external review organization does not have a conflict of interest as set forth in subsection 4 of NRS 683A.371 ; and (f) Submit a copy of the determination regarding an external review to: (1) The insured; (2) The physician of the insured; (3) The authorized representative of the insured, if any; and (4) The managed care organization. 3. A written affidavit that: (a) The information contained in the application and any accompanying materials are complete and correct; (b) The external review organization will conduct external reviews in accordance with NRS 695G.241 to 695G.310 , inclusive; (c) The external review organization and any employee, agent or contractor of the external review organization will avoid a conflict of interest as set forth in subsection 4 of NRS 683A.371 ; and (d) The external review organization is not affiliated with: (1) A health care plan; or (2) A national, state or local trade association. 4. All applicable fees required, including, without limitation, all applicable fees required pursuant to NAC 683A.640 , for the issuance of a certificate to conduct external reviews.