Four things to know:
1. The law aims to protect patients from receiving a surprise out-of-network bill. These bills occur when a patient receives care at an in-network facility, but the caregiver is not in their insurance provider’s network.
2. The law, which updates a 2017 measure, allows patients who receive a surprise out-of-network bill to seek a dispute resolution by submitting a request through the Arizona Department of Insurance. The department does not resolve the dispute, but examines the complaint to determine whether it qualifies as a bill tobe disputed, according to the report.
3. When a complaint qualifies as a surprise out-of-network bill, the department of insurance will help schedule an informal settlement conference involving the insurer, the medical provider and the patient, the report states. Arbitration would be the next step if an agreement is not reached.
4. The law doesn’t cover all billing disputes. For instance, patients may only dispute bills of at least $1,000, and patients enrolled in HMOs don’t qualify to have their disputes resolved..
Access the full Ahwatukee Foothills News report here.
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