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The Division would like to let interested stakeholders know that the Commissioner is now accepting applications for those who wish to be considered for inclusion as qualified arbitrators for the Division's Out-of-Network Health Care Payment Arbitration Program as authorized by HB 19-1174, Concerning Out-of-Network Health Care Services Provided to Covered Persons.
All arbitrators participating in the arbitration program must apply to the Commissioner for inclusion and are reviewed by the Division to ensure they meet the necessary qualifications and requirements. The arbitrator appointed by the Commissioner must:
- Be independent, not affiliated with a carrier, health care facility, or provider, or any professional association of carriers, health care facilities, or providers
- Not have a personal, professional, or financial conflict with any parties to the arbitration
- Demonstrate experience with health care billing and reimbursement rates
- Demonstrate completion of arbitration training
- Demonstrate that they are in good standing with a state agency that regulates attorneys in a state in which they practice
- Provide an expense and fee schedule for what they will charge to complete an arbitration
The arbitration program is applicable for those claims incurred on-or-after January 1, 2020, and is available for out-of-network providers and out-of-network facilities who believe that the payment they received from a carrier was not sufficient given the complexity and circumstances of the services provided.
Applications will be accepted on an ongoing basis and will be processed in the order in which they are received.
Additional information concerning the Out-of-Network Health Care Payment Arbitration Program is available on the Division's website via the button below:
Please do not reply to this email as your response will not be read or forwarded.
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