Arbitration of Payment Issues

  1. Law
  2. Georgia Code
  3. Insurance
  4. Surprise Billing Consumer Protection Act
  5. Arbitration of Payment Issues

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  1. If an out-of-network provider concludes that payment received from an insurer pursuant to Code Section 33-20E-4 or 33-20E-5 or if an out-of-network facility concludes that payment received from an insurer pursuant to Code Section 33-20E-4 is not sufficient given the complexity and circumstances of the services provided, the provider or facility may initiate a request for arbitration with the Commissioner. Such provider or facility shall submit such request within 30 days of receipt of payment for the claim and concurrently provide the insurer with a copy of such request.
  2. A request for arbitration may involve a single patient and a single type of healthcare service, a single patient and multiple types of healthcare services, multiple patients and a single type of healthcare service, or multiple substantially similar healthcare services in the same specialty on multiple patients.

(Code 1981, §33-20E-9, enacted by Ga. L. 2020, p. 210, § 1/HB 888.)

Code Commission notes.

- Pursuant to Code Sectiton 28-9-5, in 2020, "Code Section 33-20E-4" was substituted for "Code Section 3-20E-4" in the middle of the first sentence of subsection (a).


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