The Balance Billing Protection Act directs the Office of the Insurance Commissioner (OIC) to develop a list of approved arbitrators or entities that provide arbitration for balance billing disputes.
Below is the current list of approved arbitrators and organizations available to preside over a balance billing dispute.
Apply to be a balance billing arbitrator.
How balance billing arbitration works
Parties to arbitration select an arbitrator or entity from the list. If the parties cannot agree, the OIC will narrow the list to five options. If the parties still cannot reach agreement, the OIC will choose the arbitrator from the narrowed list.
Once selected, the arbitrator presides over baseball style arbitration between health care providers, facilities, and carriers. Arbitrators determine their own compensation rates, and the parties to arbitration split the cost regardless of who prevails, unless a party defaults.
Rules applicable to arbitration can be found in RCW 48.49 (leg.wa.gov) and WAC 284-43B.
Approved individual arbitrators
Individual | Contact information | Healthcare/ medical-related experience | Other experience |
---|---|---|---|
Bender, John | Bender Law PLLC | No | 20 years’ experience training arbitrators; 35 years’ experience as an arbitrator in civil disputes |
Garcia, Page | P.O. Box 66208 | Yes | Attorney since 2011; experience in collective bargaining contract negotiations/adjudication/ADR, federal and Washington state workers' compensation Labor & Industries claims and appeals |
Paulich, Patrick | 701 Pike St., #1400 | Yes | 39 yrs’ experience as an insurance defense attorney with 15-20 plaintiff personal injury cases |
Philip, Sasha | P.O. Box 82614
| No | Attorney since 2002; 5 years’ full-time dispute resolution professional, mediating and arbitrating disputes in both litigated and non pre-litigation settings |
Brown, Lisa | 205 SE Spokane Street Ste 300 | Yes | Commercial arbitration panel member for the American Arbitration Association; represents providers/facilities; licensed in Oregon and Washington |
Siegel, Howard | 9916 Lavera Drive | Yes | Texas attorney since 1993; over 10 years of arbitration experience including over 60 medical arbitrations |
Dill, Jr., Terrance D. | West, Webb, Allbritton & Gentry, PC | Yes | Texas attorney since 1992; has served as arbitrator in health care related matters 116 times. |
Ginsberg, Carl | Ginsberg ADR Group Visit their website (https://ginsbergadrgroup.com) | Yes | Former state court trial judge (12 years), Texas attorney since 1995 and also licensed to practice in New York; has served in capacity as ALJ/arbitrator/judge/etc. in healthcare related matter 10 times. |
Cohen, Murry | Hon. Murry Cohen
| Yes | Texas Judge; Texas attorney since 1972; has served & currently serves as arbitrator in billing disputes among insurers & providers for ten years. |
Stevens, Rhea | Med Arb Well, LLC Visit their website: (www.MedArbWell.com) | Yes | Texas attorney since 1992; has served in capacity of arbitrator/ALJ/etc. in healthcare related matter 90 times. |
Clayton, Gary | Dr. Gary Clayton 5057 Keller Springs Rd. Dallas, TX 75248 214-794-4424 Visit their website:
| Yes. | 15 years’ mediation experience in conflicts involving healthcare disputes as an Alternative Dispute Resolution professional; has served as an arbitrator in healthcare related matters over 200 times. |
Huffman, Dana | Huffman Law 1143 Rockingham Ste. 107 Richardson, TX 75080 972-713-7757 danahuffman@law.com Visit their website: | Yes. | Texas attorney since 1994. Has served as arbitrator in healthcare related matters 75 times. |
Approved entities that provide arbitration
Organization | Contact information |
---|---|
American Arbitration Association | 6000 Fairview Rd |
American Health Law Association | 1620 I Street NW |
Pacific ADR, LLC | 1400 12th Avenue SE |
MAXIMUS Federal | 3750 Monroe Avenue |