Important Information Regarding the New Jersey Health Claims Authorization, Processing and Payment Act - Arbitration Program

The New Jersey Department of Banking and Insurance issued Bulletin 07-14 to provide guidance regarding the New Jersey Health Claims Authorization, Processing and Payment Act (“HCAPPA”) – Arbitration Program (Public Law 2005, C.352). The Bulletin requires carriers to establish an internal claims appeal mechanism and permits health care providers to request binding arbitration if the provider is dissatisfied with the outcome of a claim(s) appealed through the carrier’s internal claims appeal mechanism. Effective July 2, 2007, parties with claims eligible for arbitration may complete an application (accessible at https://njpicpa.maximus.com/NJ_Claim_Arbitration/Pages/Main.aspx) for submission along with the required review and arbitration fees to the Program for Independent Claims Payment Arbitration (“PICPA”). Complete details regarding the Arbitration Program can be found in NJ Bulletin 07-14

The contact person for the Arbitration Program at WellChoice Insurance of New Jersey, Inc. and WellChoice HMO of New Jersey is:

Laura Malinowski
Phone - 518-367-4502
laura.malinowski@empireblue.com