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29 chapters · 1,539 sections in this title.
A.R.S. § 20-3101 Definitions
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In this article, unless the context otherwise requires: 1. "Adjudicate" means an insurer's decision to deny or pay a claim, in whole or in part, including the decision as to how much to pay. 2. "Clean claim" means a written or electronic claim for health care services or benefits…
A.R.S. § 20-3102 Timely payment of health care providers' claims; grievances
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A. A health care insurer shall adjudicate any clean claim from a contracted or noncontracted health care provider relating to health care insurance coverage within thirty days after the health care insurer receives the clean claim or within the time period specified by contract. …
A.R.S. § 20-3103 Denial of claims; review of claims
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(Eff. 7/1/26) Before a health care insurer may deny a claim that was submitted by a provider on the basis of medical necessity, the medical director shall individually review the denial. During each individual review, the medical director shall exercise independent medical judgme…
A.R.S. § 20-3111 Definitions
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In this article, unless the context otherwise requires: 1. "Arbitration" means a dispute resolution process in which an impartial arbitrator determines the dollar amount a health care provider is entitled to receive for payment of a surprise out-of-network bill. 2. "Arbitrator" m…