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Get Az Surprise Out-of-network Billing Dispute Resolution (soonbdr) Request 2019-2024

ArizonaDepartmentofInsurance SURPRISEOUTOFNETWORKBILLING DISPUTERESOLUTION(SOONBDR)INSTRUCTIONS Before you submit a request for surprise billing dispute resolution Itisimportantthatyouknowthefollowing: 1.Onlysubmitarequestfordisputeresolutionifeligible.Yourhealthinsurercanhelpyoudetermineeligibilityandcanprovide informationyouneedtocompletetherequestform.ArizonaRevisedStatutes(ARS)203111through203119defi.

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