VA | The Virginia Bureau of Insurance has issued Administrative Letter 21-04.
The Bureau of Insurance administers an arbitration process pursuant to § 38.2-3445.02 of the Code of Virginia that addresses balance billing claims disputes between carriers and providers. Along with the Department of Health and the Board of Medicine, the Bureau shares enforcement authority over providers related to potential patterns of violations of § 38.2-3445.01 without corrective action.
This Administrative Letter:
- Sets a standard for the submission of arbitration requests to address and avoid filings with such frequency as to indicate a general business practice;
- Reminds the parties involved in a payment dispute of the requirement in § 38.2-3445.01 F to engage in good faith negotiation; and
- Reminds carriers of the requirement in § 38.2-3445.01 F to pay a commercially reasonable amount.