Where can I get information about the availability of mediation as an option to resolve Medicare beneficiary complaints?

September 20, 2009 by admin

Mediation is an option available to resolve quality of care complaints under Medicare. It is an opportunity for you and your doctor or hospital to tell your story, respond to each other, and resolve your concerns about the way you were treated. The session usually will be conducted face-to-face and facilitated by an impartial third person (the mediator). If you have difficulty traveling, you may participate by phone. You and your doctor/provider determine the solution to your complaint. If you agree on a way to resolve your concerns, the mediator writes up an agreement that is acceptable to both sides. If no agreement can be reached, the patient can choose to let the case return to the traditional review process. The program is strictly confidential. Other than the agreement, nothing will be documented and information shared during the mediation cannot be used in any legal proceedings. There is no cost to you. Mediation will not be available if a serious quality of care concern appears to be involved. A Quality Improvement Organization (QIO) physician will review your case to determine if it is suitable to be resolved by Mediation. Participation is voluntary, and either party may withdraw at any time. If you choose to participate, your benefits under Medicare are not affected. For additional information, please go to the Helpful Contacts section of Medicare's Web site, click on the 'specific organization' option, select QIO - Quality Improvement Organization, select your State, then click on the Find Contacts for this Organization button below. The resulting page will contain the phone number for the QIO - Quality Improvement Organization in your State.