Out-of-Network Payment Arbitration Program

An arbitration program for out-of-network provider and facility carrier reimbursement disputes

House Bill 19-1174 - Concerning out-of-network health care services provided to covered persons, established an arbitration program for out-of-network providers and out-of-network facilities who believe that the payment they received from a carrier was not sufficient given the complexity and circumstances of the services provided. The Division of Insurance (DOI) is tasked with managing the arbitration program.

Overview of the Arbitration Process

Arbitration Request Form [Fillable PDF] to be sent to insurance company and DOI

Arbitration Decision and Reporting Form [Fillable PDF] - to be sent by the arbitrator to the health care provider / facility, insurance company and the Division of Insurance

Apply to be an Arbitrator for the Out-of-Network Arbitration Program (includes requirements)

Colorado Regulation 4-2-65 - Concerning the Establishment of a Carrier Payment Arbitration Program for Out-of-Network Providers

List of Qualified Arbitrators and Fees for the Out-of-Network Payment Arbitration Program

 

For questions about this program, please contact the Division of Insurance at dora_doi_arbitration@state.co.us