Arizona: Industrial Commission reviews payment under fee schedule
The changes include adding language that a payer's explanation of review must contain sufficient information to allow a physician to determine whether the amount of payment is correct. The explanation of review should also contain contact information for entities who reviewed the medical billing for the payer and parties with a written contract signed by the physician allowing the party or other third party to access and pay rates different from those under the fee schedule. Also, the proposed changes state that nothing in the fee schedule precludes a physician from entering into a separate contract that governs fees. If there is no contract, reimbursement will be made according to the fee schedule.
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April 11, 2011
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