Ariz. Admin. Code § 20-6-2405

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

Section R20-6-2405 - Before the Arbitration

A. Enrollee's duties. Before the Arbitration, the enrollee shall:

1. Pay or make arrangements in writing to pay to the health care provider the amount stated by the health insurer in the Informal Settlement Teleconference which shall be the total amount of the enrollee's cost sharing requirements due for the health care services that are the subject of the qualifying surprise out-of-network bill.

2. Pay to the health care provider any amount that the enrollee has received from the health insurer as payment for the health care services that are the subject of the qualifying surprise out-of-network bill.

B. Health insurer's duties. Before the Arbitration, the health insurer shall remit any amount due to the health care provider if the health care insurer pays for out-of-network services directly to health care providers and the health insurer has not remitted any amounts due.

Ariz. Admin. Code § R20-6-2405

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