Surprise Out-of-network Bill Dispute Resolution
BEFORE SUBMITTING YOUR REQUEST FOR ARBITRATION USING THE ONLINE PORTAL:
STEP 1: Review information on this web page (https://insurance.az.gov/soonbdr) and confer with your health insurer to determine whether your healthcare bill qualifies as a surprise bill that is eligible for the dispute resolution process.
STEP 2 (IMPORTANT!): Scan and save to your computer:
- Your insurance card, front and back
- Correspondence (letters, memos, bills, etc.) between you, the provider, and the insurer relating to this bill
- Other information that will help explain this matter
STEP 3: Use the online portal link below (link is external) to submit your request to the Department:
*IMPORTANT: The portal only allows one opportunity to attach documents. It is important that you complete STEP 2 before going to the online portal so you will be able to upload all your documents as part of your request for arbitration. The portal will transfer your documents to us in a secure, encrypted manner.
If you were unable to attach all related documents, do NOT submit a new request. You may contact us at [email protected] and we will provide an alternate method to obtain the documents. Please make sure to reference your Dispute number.
ONLINE PORTAL: https://azinsurance.online/soonbdrs