20-3103. Denial of claims; review of claims
54 words·~1 min read·
/az/title-20/20-3103A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(Eff. 7/1/26)
Before a health care insurer may deny a claim that was submitted by a provider on the basis of medical necessity, the medical director shall individually review the denial. During each individual review, the medical director shall exercise independent medical judgment and may not rely solely on recommendations from any other source.