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Desk Arbitration

 State: NY


SWCB Announces Criteria for Desk Arbitration of Billing Disputes


The New York State Workers" Compensation Board has posted criteria for the "desk arbitration" of health care billing disputes called for in Gov. Andrew Cuomo's 2013-2014 budget.


Cuomo's Business Relief Act provided for arbitration by a single arbitrator of disputes involving $1,000 or less. Disputes involving larger amounts of money must be arbitrated by a panel of health care providers, unless a health care provider agrees to desk arbitration.


SWCB Chairman Robert Beloten said desk arbitrations are based on a paper submission, rather than a hearing before an arbitration panel. Health care providers must submit Form HP-1 with an original signature and a check for arbitration fees.


Providers and carriers or self-insured employers each have 30 days from the board's

acknowledgement of an arbitration to submit any supporting documents. After the deadline for submissions has expired, Beloten said, an arbitrator chosen by the chairman will review the evidence and issue a written decision.


The board has revised HP-1, the Health Provider's Request for Decision on Unpaid Medical Bill(s), to include a check box to allow providers to select desk arbitration of disputes of more than $1,000.


Beloten said the board has established new arbitration fees that range from $50 for desk arbitration of  disputes involving amounts of up to $1,000, to $500 for panel arbitrations involving $5,000.01 or more.


Questions should be directed to the SWCB Medical Director's Office at 800-781-2362.


Further details are here.


Source: SWCB


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