1/17/2019: We are working with a vendor to create an easy-to-use system for submitting requests for surprise bill dispute resolution requests, and we estimate that system will be available starting February 17, 2019. We will also publish a form that a person can complete and submit through the mail with required attachments; however, submitting information using the online system will likely be easier and less expensive.
IMPORTANT! Requests can only be submitted for health care services a person received on or after January 1, 2019. A person should first work with the health insurer to determine the amount the portion of the bill that the insurer will pay and whether the bill qualifies for the dispute resolution process under Arizona law. For additional information, view the section of this webpage entitled, "I got a surprise bill. What can I do about it?"