Out-of-Network Health Insurance Dispute Resolution

The act makes changes to the dispute resolution process between health insurance carriers (carriers) and out-of-network health-care providers (providers) by requiring a carrier to provide, with each payment made to a provider, a remittance advice that: Identifies when the associated health benefit plan is regulated by the state and when the payment is made pursuant to services received from an out-of-network provider or at an out-of-network facility; andProvides the carrier's median in-network reimbursement rate for out-of-network claims.(Note: This summary applies to this bill as enacted.)