Colorado HB19-1174 Out-of-Network Health Care Services

New Surprise/Balance Billing Disclosure Form

Payment of Out-of-Network Health Care Services Determined to Apply to Massage Therapists who Work with Doctors or Insurance

As part of the implementation of House Bill 19-1174 Out-of-network Surprise Billing, the Division of Professions and Occupations (DORA) is providing a sample disclosure form that meets the requirements of the bill and associated Rules adopted by the Division’s Director.

Disclosure form- PDF
Disclosure form – DORA link