AzDA 2023 Accomplishments

Allows transparency of the insurance profit margin which would give light to how much of the premiums are going into patient care or profiting the insurance company.

Medical loss ratio transparency: requires the insurance companies to report actual numbers from the prior year in March and post in August on how much was actually used on patient care. Insurance companies will be required to be transparent about how much was used for patient care and how much was profit. This is the first step to holding insurance companies accountable for patient utilization and provider rates.

HB1226 (Shope) Custodian of Records

https://www.azleg.gov/legtext/56leg/1R/laws/0118.pdf
Protects dentist employees of a large or small or large group practice, since it defines the owner as the custodian of records and not the treating dentist. 

SB1602 (Smith/Shamp) CRNA elimination of oversight

Started as a bill that would have put the CRNA on the same playing field as the Dental Anesthesiologist.  The bill was amended to allow the BODEX ad-hoc committee to complete its work and give recommendations to the Board.

Addresses explanation of the process of denials and appeals. The provider can request a hearing and can appeal the decision 180 days after written notice. Insurance companies need to respond within 30 days. Outlines what can be included in the dispute. Remittance must be done within 15 days.

Credentialing: Adjust the credentialing from 100 to 45 days. A company must respond within 7 days with deficiencies. Insurance Companies may not deny claims after a complete submission of an application