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Delaware Form to respond to health care reimbursement arbitration

State:
Delaware
Control #:
DE-19-AB
Format:
Word
Instant download
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Public form

Description

Form to respond to health care reimbursement arbitration Delaware Form to respond to health care reimbursement arbitration is a form used for filing an arbitration claim with the Delaware Health Care Cost Containment Council (HCC CC). The form is used by a health care provider to dispute the amount of a health care reimbursement received. The health care provider must submit the form along with supporting documents to the HCC CC in order to initiate the arbitration process. There are two types of Delaware Form to respond to health care reimbursement arbitration: Form DHCC-AR1, which is used for disputes involving medical services, and Form DHCC-AR2, which is used for disputes involving pharmacy services. Both forms must be completed in full, and signed and dated by the health care provider initiating the arbitration claim. The form must also be accompanied by supporting documents that explain the health care provider’s position on the reimbursement.

Delaware Form to respond to health care reimbursement arbitration is a form used for filing an arbitration claim with the Delaware Health Care Cost Containment Council (HCC CC). The form is used by a health care provider to dispute the amount of a health care reimbursement received. The health care provider must submit the form along with supporting documents to the HCC CC in order to initiate the arbitration process. There are two types of Delaware Form to respond to health care reimbursement arbitration: Form DHCC-AR1, which is used for disputes involving medical services, and Form DHCC-AR2, which is used for disputes involving pharmacy services. Both forms must be completed in full, and signed and dated by the health care provider initiating the arbitration claim. The form must also be accompanied by supporting documents that explain the health care provider’s position on the reimbursement.

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Delaware Form to respond to health care reimbursement arbitration