Ariz. Admin. Code § 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.
Notes
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