Ariz. Admin. Code § 20-6-2404

Current through Register Vol. 30, No. 45, November 8, 2024

Section R20-6-2404 - Arbitrators

A. Contracted entities. The Department shall contract with one or more persons to provide Arbitrators. The Department must have a list of at least four Arbitrators to assign to Arbitrations. The Department shall publish the list of contracted entities and a list of each entity's qualified Arbitrators on its website.

B. Arbitrator Qualifications. Any person contracting with the Department must be able to provide Arbitrators who possess at least three years of experience in health care services claims.

C. Alternative Arbitrators. A health insurer and provider may mutually agree to use an Alternative Arbitrator if either the health insurer or the health care provider objects to an Arbitrator appointed by the Department.

D. Appointment of an Arbitrator.

1. The Department shall appoint an Arbitrator for each Arbitration.

2. If the health insurer and health care provider do not agree to the Arbitrator appointed by the Department, they shall either:

a. Mutually agree to use an Alternative Arbitrator; or

b. Participate in the following procedure:

i. The Department shall assign three Arbitrators.

ii. The health insurer shall strike one Arbitrator.

iii. The health care provider shall strike one Arbitrator.

iv. If one Arbitrator remains, the Department shall appoint the remaining Arbitrator to the Arbitration.

v. If the health insurer and health care provider strike the same Arbitrator, the Department shall randomly assign the Arbitrator from the remaining two Arbitrators.

Ariz. Admin. Code § R20-6-2404

New Section made by exempt rulemaking at 25 A.A.R. 155, effective 1/2/2019.