The Arizona Department of Insurance wants to have new rules by the New Year to clarify the process for beneficiaries disputing out-of-network bills; comments on the proposed rules are due by September 30, 2018.
ADOI will also schedule a public hearing after the close of the comment period.
Check the ADOI website for time and location.
The agency’s dispute process lays out how beneficiaries can ask for help in settling qualifying bills received from out-of-network providers. In its notice of proposed rulemaking ADOI stated,
The process brings together the enrollee, health insurer and healthcare provider to resolve the billing dispute in an informal settlement teleconference, and if a settlement cannot be reached, provides arbitration to resolve the dispute over the qualifying bill between the health insurer and healthcare provider.
Reported by Debbie Johnston, senior VP of policy development at the Arizona Hospital and Healthcare Association (AzHHA), the ADOI is also:
- Drafting notices to be used in dispute resolution process
- Procuring arbitrators
- Developing an online system for consumers to request dispute resolution and for insurers and providers to provide information and documents pertaining to cases
- Creating an employee position to administer the dispute resolution process
ADOI has also developed a website to assist consumers who may have received a surprise out-of-network bill. ADOI welcomes any feedback on the new website, which can be sent to firstname.lastname@example.org
The public may submit comments on the ADOI’s proposed rules by email at mailto://email@example.com
Visit the ADOI website