Live Webinar: Healthcare Appeals and Provider Grievances

Time9:00am - 10:00am

CEUs1 CEUs

LocationZoom

FormatLive Webinar

▣Overview

A general overview of the healthcare appeals and provider grievance processes under Arizona insurance law.

Zoom link to be sent closer to the program date. For Zoom system requirements, please visit this site.

◎Learning Objectives

This session will provide an overview of providers' rights to appeal denied claims and services, including updates to the health care appeal laws effective January 1, 2025.
We will also cover insurer mandates for addressing provider grievances regarding credentialing and payment disputes.
The speakers will explain when and how to submit a healthcare appeal versus a provider grievance, as well as applicable timeframes.
The agency will provide an overview of other Arizona laws that may be of interest to providers.

▦Schedule

9:00am- 10:00am

📍Location

Zoom

Speakers

Steve Fekety

Steve Fekety is the Health Insurance Compliance Administrator and was previously a Senior Insurance Analyst for the Arizona Department of Insurance and Financial Institutions. In this role, his primary focus is on ensuring compliance with state and federal regulations within the healthcare sector. His key responsibilities include evaluating the licensure of new entrants into the health market and monitoring critical compliance metrics, such as network adequacy standards, healthcare timely pay, and provider grievance standards.

Audrey Franklin

Audrey Franklin has over 30 years of experience in insurance, with the last 25 years at the Arizona Department of Insurance and Financial Institutions (DIFI). Audrey previously handled provider grievances and currently serves as a supervisor in the Department's Consumer Services Division, Life & Health Section, overseeing consumer complaints against life and health (including dental) insurers, along with oversight of the Health Care Appeals program.