HB2035 is a bill that amends existing Arizona Revised Statutes related to health insurance, specifically focusing on health care claim denials, disputes, and provider credentialing processes. The bill introduces new requirements for health care insurers when denying claims, such as providing contact information for someone who can answer questions about the denial and detailed reasons for denials based on lack of medical necessity. It also outlines the rights of health care providers to appeal and dispute such denials, including the process for requesting a hearing with the Department of Insurance and Financial Institutions (DIFI) if grievances are unresolved.

Additionally, the bill changes the credentialing process for health care providers, reducing the time frame for insurers to complete credentialing from 100 to 45 days after receiving a complete application. It also mandates that insurers pay claims for covered services retroactively to the date of the provider's complete credentialing application, provided the provider has a fully executed contract with a network plan. The bill defines various terms related to the credentialing process and removes the ability of a health care insurer's designee to credential providers. The bill becomes effective on the general effective date.

Statutes affected:
Introduced Version: 20-3101, 20-3102, 20-3103, 20-3104, 20-3451, 20-3453, 20-3456, 20-1137, 20-2533, 12-908, 20-3321
House Engrossed Version: 20-3101, 20-3102, 20-3103, 20-3104, 20-3451, 20-3453, 20-3456, 20-1137, 20-2533, 12-908, 20-3321