Surprise Billing: What Do The Statuses Mean?


  • New- This case has been submitted but has not yet been accepted or rejected by the GA OCI Administrator.
  • Waiting for Payor This case is waiting on more information to be submitted by the payor.
  • Waiting for Applicant- This case is waiting on more information to be submitted by the applicant or provider.
  • Pending Settlement- This case has been accepted by OCI and the provider and payor should be attempting to negotiate a settlement offline, or uploading additional supporting documentation to the case via GovLink.
  • Settlement Reached- GA OCI was notified by either the provider, payor, or both that a settlement was reached on the case.
  • In Arbitration- This case was unable to reach a settlement and has been sent or is in process of being sent to the contracted arbitrator.
  • Arbitration Complete- The case was sent to arbitration and the arbitration process has been completed.
  • Closed- the case was determined to no longer be valid or need to pursued and has been closed out.
  • Needs Review- Additional documentation was submitted to the case by either the payor or the provider and is pending review from the OCI attorney to be accepted into the case.