2017 Arizona Revised Statutes
Title 20 - Insurance
§ 20-3118 Surprise out-of-network bills; annual report

20-3118. Surprise out-of-network bills; annual report

(Eff. 1/1/19)

A. On or before December 31, 2019 and each December 31 thereafter, the department shall report on the resolution of disputed surprise out-of-network bills. The report shall include:

1. The total number of inquiries regarding dispute resolution of surprise out-of-network bills.

2. The total number of requests that did not qualify for dispute resolution and the reasons why the disputed bills did not qualify.

3. The number of requests that qualified for dispute resolution.

4. The most common requests for dispute resolution by health care provider specialty area.

5. The most common requests for dispute resolution by health care service.

6. The number of requests for dispute resolution by geographic area in this state.

7. The most common requests for dispute resolution based on the type of health care facility in which the health care services were provided.

8. The number of requests for dispute resolution that were settled during a settlement teleconference.

9. The number of requests for dispute resolution that were settled during arbitration.

10. The number of times a health insurer, a health care provider or the provider's representative or an enrollee failed to attend the settlement teleconference.

11. The average percentage by which disputed surprise out-of-network bills were reduced from the initially billed amount.

12. Any additional information that the department determines is relevant in evaluating the effectiveness of the dispute resolution process.

B. The department shall submit the report to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of the report to the secretary of state.