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Delaware Legal description of health care reimbursement arbitration (Regulation 1313)

State:
Delaware
Control #:
DE-17-AB
Format:
PDF
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Legal description of health care reimbursement arbitration (Regulation 1313) Delaware Legal description of health care reimbursement arbitration (Regulation 1313) is a process which allows for the resolution of disputes between health care providers and insurers concerning health care reimbursement. This regulation provides for the submission of disputes to an independent arbitrator appointed by the Delaware Insurance Commissioner, who serves as the decision maker. The arbitrator reviews the evidence presented by each side and renders a decision that is binding on both the health care provider and the insurer. The decision may award damages to the provider, require the insurer to pay the provider, order the insurer to pay the provider additional sums, or order the insurer to provide additional services to the provider. There are two types of health care reimbursement arbitration regulated by Regulation 1313: voluntary arbitration and mandatory arbitration. Voluntary arbitration is initiated by a written agreement between the parties and may be used in any health care reimbursement dispute. Mandatory arbitration is required by Delaware law and applies to all disputes involving the non-payment of medical bills over $250.

Delaware Legal description of health care reimbursement arbitration (Regulation 1313) is a process which allows for the resolution of disputes between health care providers and insurers concerning health care reimbursement. This regulation provides for the submission of disputes to an independent arbitrator appointed by the Delaware Insurance Commissioner, who serves as the decision maker. The arbitrator reviews the evidence presented by each side and renders a decision that is binding on both the health care provider and the insurer. The decision may award damages to the provider, require the insurer to pay the provider, order the insurer to pay the provider additional sums, or order the insurer to provide additional services to the provider. There are two types of health care reimbursement arbitration regulated by Regulation 1313: voluntary arbitration and mandatory arbitration. Voluntary arbitration is initiated by a written agreement between the parties and may be used in any health care reimbursement dispute. Mandatory arbitration is required by Delaware law and applies to all disputes involving the non-payment of medical bills over $250.

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Delaware Legal description of health care reimbursement arbitration (Regulation 1313)