California Insurance Code

§ 10112.81

INS § 10112.81 Effective Jan 1, 2021Div. 2 · Part 2 · Ch. 1 · Art. 1

Statute text

(a)(1) By September 1, 2017, the commissioner shall establish an independent dispute resolution process for the purpose of processing and resolving a claim dispute between a health insurer and a noncontracting individual health professional for services subject to subdivision (a) of Section 10112.8.

(2)Prior to initiating the independent dispute resolution process, the parties shall complete the insurer’s internal process.

(3)If either the noncontracting individual health professional or the insurer appeals a claim to the department’s independent dispute resolution process, the other party shall participate in the appeal process as described in this section.

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Legislative history

Amended by Stats. 2020, Ch. 278, Sec. 2. (AB 2157) Effective January 1, 2021.