6.6.8604    NOTICE OF DISPUTE – CONTENT

(1) After determining that an insurer or health plan and an air ambulance service cannot resolve a billing dispute, either party may communicate in writing to the other party its intent to submit the dispute to this arbitration process. Within 30 days of that communication, the parties shall file a notice of dispute with the commissioner. The notice shall be mailed to: Office of the Montana State Auditor, c/o Chief Legal Counsel, 840 Helena Avenue, Helena, MT 59601.

(2) The notice must specify:

(a) the parties to the dispute;

(b) the date(s) of service;

(c) the insured and (if different) the individual transported by the air ambulance service;

(d) the amount in controversy after insurer or health plan payment;

(e) whether the parties have agreed upon an independent reviewer, and if so, his or her contact information; and

(f) the contact information of each party's representative for purposes of the dispute.

(3) If multiple billing disputes between the parties are ripe for dispute resolution when the notice of dispute is filed, whether or not involving transport of the same individual, the parties shall identify all such disputes in the notice. The disputes must be consolidated and the assigned independent reviewer shall hear all identified disputes.

(4) Parties shall make reasonable efforts to jointly file the notice of dispute with the commissioner. If one party is uncooperative, a party may file the notice of dispute without the participation of the uncooperative party. In such a case, the filing party must document in the notice the efforts made to coordinate with the other party and must serve a copy of the notice on the uncooperative party by mail to the registered agent, or if the entity does not have a registered agent in Montana, to the last known business address of the uncooperative party.

(5) The parties shall notify each other of the acceptable form of service before or at the time the notice of dispute is filed. If a party does not specify a form of service, service shall be effectuated by mail to the entity's registered agent, or if the entity does not have a registered agent in Montana, to the last known business address of the entity.

 

History: 2-18-720, 20-25-1320, 33-2-2306, MCA; IMP, 2-18-718, 2-18-719, 2-18-720, 20-25-1318, 20-25-1319, 20-25-1320, 33-2-2304, 33-2-2305, 33-2-2306, MCA; NEW, 2017 MAR p. 1877, Eff. 10/14/17.