AR| Arizona Department of Insurance Bulletin 2025-01 (INS) outlines updates to Arizona’s Health Care Provider Timely Payment and Grievance Law, emphasizing legislative amendments, insurer obligations, and reporting requirements.
Key points:
- Legislative Updates: The 2024 amendments (HB2444) expand grievance definitions, introduce new reporting requirements for insurers, and clarify provider rights regarding payment collection for non-covered or denied services.
- Insurer Responsibilities: Insurers must process clean claims within specified timelines, maintain effective internal grievance systems, and ensure compliance when delegating functions to third parties.
- Reporting and Monitoring: Insurers are required to submit semi-annual grievance reports detailing claim disputes, resolution timelines, and overturned decisions. These reports aid the Department of Insurance in identifying regulatory concerns.
The bulletin supersedes previous guidance and reinforces insurers’ accountability under ARS §§ 20-3101 and 20-3102.