Duty LXD-6834
Handles health records, in Arizona
Denial of claims; individualized review requirementsince 2 lines
A.R.S. ยง 20-3103 · Read the law's page
- If you are a health care insurer, do not deny a claim submitted by a provider on the basis of medical necessity without a medical director individually reviewing the denial and exercising independent medical judgment.when it serves a financial business
- The reviewing medical director may not rely solely on recommendations from any other source, including an automated or AI-assisted recommendation, in making that individualized review.when it serves a financial business
Health information organizations: no re-identification of received de-identified informationin force1 line
Health information organizations, section 36-3804(F) · Read the law's page
- If you receive de-identified information from a health information organization, do not use it, alone or in combination with other information, to identify an individual (section 36-3804(F)).
Health information organizations: transfer of de-identified health information for researchin force2 lines
Health information organizations, section 36-3805(C) · Read the law's page
- If you are a health information organization, do not transfer individually identifiable health information or de-identified health information that is accessible through the health information exchange to any person or entity for the purpose of research, or for use as part of a set of data for an application for grant or other research funding, unless the health care provider obtains the individual's consent for the transfer (section 36-3805(C)).
- Have a health care provider participating in the organization document that it has provided a notice of transfer, in the form of the individual's signature showing the individual has received and read and understands the notice and consents to the transfer; the notice must be in at least twelve-point type and describe the purposes of the transfer (section 36-3805(C)).