The proposed bill would update the Arizona Revised Statutes by introducing new requirements and timelines for the health insurance provider credentialing process. Specifically, it mandates that health insurers complete the credentialing process within 60 calendar days and load applicant information into their billing systems within 30 days of receiving a complete application. Insurers would also be required to acknowledge receipt of applications within seven days and provide detailed notices for any incomplete applications, informing applicants within the same timeframe. The bill further stipulates that insurers cannot toll the processing time more than three times for incomplete applications.

Additionally, the bill modifies existing definitions and repeals section 20-3456, establishing new provisions that allow providers to receive payment for services rendered during the credentialing process under certain conditions. Claims submitted within one year cannot be denied based on timing if they meet the new statutory requirements. The bill also emphasizes the need for health care providers to disclose their credentialing status and estimated costs to patients prior to service delivery. Overall, these updates aim to streamline the credentialing process, enhance claims processing efficiency, and improve communication and transparency between health insurers and providers.

Statutes affected:
Introduced Version: 20-3451, 20-3453, 20-3456, 20-3321
Senate Engrossed Version: 20-3451, 20-3453, 20-3454, 20-3456, 20-3459, 20-3321
House Engrossed Version: 20-3451, 20-3453, 20-3454, 20-3456, 20-3459, 20-3321