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  • COMPLIANCE: Health Care Appeals

COMPLIANCE: Health Care Appeals

Health Care Appeals Transmittal Form

This document must accompany each appeal submitted to the Arizona Department of Insurance.  An appeal can only be submitted to the Department after the insurer's appeals process has been exhausted. 

Insurers

  • Licensing/Registration
    • Acquisition and Holding Company Registration
    • Captive Insurer/Domestic RRG
    • Insurer
    • Life Care Provider
    • Life Settlement Provider
    • Premium Finance Company
    • Purchasing Group
    • Rate Service Organization
    • Rating Organization
    • Reinsurer
    • Risk Retention Group - Domestic (Captive Insurer)
    • Risk Retention Group - Foreign
    • Senior Residential Entrance Fee Contract Provider
    • Service Company
    • Surplus Lines Insurer
    • Third Party Administrator (Life/Health)
    • Utilization Review Agent
  • Trust Deposits
  • Financial Reporting for Domestic Entities
    • Acquisition/Holding Company Registration
    • Captive Insurer
    • Health Care Services Organization
    • HMDO Service Corporation
    • Life & Disability Reinsurer
    • Life Care Provider
    • Life/Disability Insurer Filing on a Health Blank
    • Life/Disability Insurer Not Filing on a Health Blank
    • Mechanical Reimbursement Reinsurer
    • Mortgage Guaranty Insurer
    • Prepaid Dental Plan Organization
    • Property/Casualty Insurer Filing on a Health Blank
    • Property/Casualty Insurer Not Filing on a Health Blank
    • Risk Retention Group
    • Title Insurer
    • Senior Residential Entrance Fee Contract Provider
    • Unaffiliated Credit Life & Disability Reinsurer
  • Financial Reporting for Foreign/Alien Entities
    • Accredited Reinsurer
    • Fraternal Benefit Society
    • Health Care Services Organization
    • Life Care Provider
    • Life/Disability Insurer Filing on a Health Form
    • Life/Disability Insurer Not Filing on a Health Blank
    • Mortgage Guaranty Insurer
    • Mutual Aid Association
    • Prepaid Legal Insurer
    • Property/Casualty Insurer Filing on a Health Blank
    • Property/Casualty Insurer Not Filing on a Health Blank
    • Reinsurer
    • Risk Retention Group
    • Title Insurer
  • Life & Health Rates, Forms & Compliance
    • Health Care Appeals
    • Life/Health/Annuity Form Filing Requirements
    • Life/Health/Annuity Advertising Filing Requirements
    • Life/Health/Annuity Rate Filing Requirements
    • Long-term Care
    • Credit Insurance
    • Life Settlement Provider
    • Health Plans Survey (Annual)
    • HIPAA Data Reporting
    • Market Conduct Exam Reports
  • Property & Casualty Rates, Forms & Compliance
    • P&C Rate & Form Filing Requirements
    • Examinations and Analysis Program
    • Market Conduct Exam Reports
    • Motor Vehicle Non-renewals Report
  • Laws, Rules and Bulletins
    • Laws and Rules
    • Rules & Rulemaking
    • Regulatory Bulletins
  • Insurance Fraud
  • Taxes
  • File a Health Care Appeal

Contact Info

Ms. Audrey Franklin

Insurance Health Care Appeals Section
100 N. 15th Avenue, Suite 261
Phoenix, AZ 85007-2630
[email protected]
602-364-2179
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