Alternative Dispute Resolution

Under our Quality Improvement Organization (QIO) contract with Medicare, Qualis Health is charged with responding to Idaho and Washington Medicare beneficiaries' complaints regarding the quality or necessity of their care. As part of our response, we may suggest mediation or facilitated resolution.

It is challenging for both providers and patients to communicate effectively. Medical terminology and processes can be technical and confusing for anyone. Misunderstandings, rather than poor quality care, are often at the root of a patient's complaint.

Mediation and facilitated resolution provide an impartial, effective means to resolve communication problems.

• Mediation may take place over the phone or face-to-face.
• In facilitated resolution, the parties do not have any direct contact. All communication occurs by phone or mail and is channeled through the facilitator.

The goal of these methods is to resolve the issue to both the patient's and the provider's satisfaction. Participation is voluntary.