Delaware Administrative Code
Title 18 - Insurance
1300 - Health Insurance General Provisions
1319 - Arbitration of Disputes Between Carriers and Primary Care and Chronic Care Management Providers
Section 1319-5.0 - Carrier Recordkeeping and Reporting Requirements
Universal Citation: 18 DE Admin Code 1319-5.0
Current through Register Vol. 28, No. 3, September 1, 2024
5.1 A carrier shall maintain written or electronic records for five years after completion of each arbitration case, documentation of each Petition for Arbitration including, at a minimum, the following information:
5.1.1 The date the petition was filed;
5.1.2 The name and identifying information of the health care provider on whose behalf the petition was filed;
5.1.3 A general description of the reason for the petition; and
5.1.4 The date and description of the arbitration decision or other disposition of the petition.
5.2 A carrier shall file with its annual report to the Department the total number of Petitions for Arbitration filed, with a breakdown showing:
5.2.1 The total number of final reimbursement decisions upheld through arbitration; and
5.2.2 The total number of final reimbursement decisions reversed through arbitration.
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