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Arbitration Makes Its Way Into Healthcare Billing

Tuesday, August, 13, 2013

Over the next several months, the number of adjustments in the healthcare industry as a result of mandatory aspects of the Affordable Care Act will certainly shift the way healthcare is viewed and delivered in this country.  One area that has received attention from healthcare professionals is that health care billing disputes for Workers Compensation.  Going through a workers’ compensation claim can be challenging especially when the employee isn’t sure what to expect and remains unclear on his or her rights.  In the past, filing a healthcare billing dispute only presented even further challenges to an already-frustrated employee. 


The Business Relief Act in the state of New York sets up a single arbitrator to manage an arbitration desk for these issues.  These healthcare billing disputes fall under the category of $1,000 or less and providers can also request desk arbitration even if the amount is more than $1,000.  As a result, the Workers’ Compensation Board modified their procedures and forms to be prepared for these changes. 


The great benefit of this new opportunity is that it will allow for a single arbitrator to review a case based on a paper submission rather than the prior method of holding a hearing before an arbitration panel.  Both sides will have 30 days from the acknowledgement of the arbitration request to submit any relevant documentation.  Desk arbitration allows participating parties the traditional benefits of an arbitrated dispute while allowing the entire case to move through the system much more quickly and allowing similar disputes to be grouped together and managed by an experienced arbitrator. 


The fees for going through desk arbitration, as opposed to panel arbitration, are also less expensive, providing more efficient solutions for those individuals having a dispute with their healthcare billing costs.  It’s hoped that this new service will allow for more expedient resolution to these claims and ultimately better service for the individuals involved