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Alternative Dispute Resolution

What is ADR?
Alternative Dispute Resolution or ADR is an opportunity for beneficiaries and/or their representatives to talk with the healthcare provider about their concerns. This can be a way to reach a better understanding about what occurred during their care, to bring some resolution or closure to the matter or to decide how to approach care in the future.

ADR is a non-adversarial means of conflict resolution. There are several ADR options available including direct phone contact with the provider or face-to-face mediation. Participation in ADR is voluntary for all involved including the beneficiary/representative and the healthcare provider.

What happens in ADR?
All participants have the opportunity to raise any concerns they have regarding the care given. For example, if mediation is agreed upon the following would take place. The mediator encourages every one to listen to the concerns of the other participants. This open communication helps all participants to better understand one another and to discuss possible solutions to the issues of concerns. The mediator has no decision-making authority; however, participants work toward a positive outcome that can be agreed upon by the end of the session.

Is ADR confidential?
Confidentiality is a key factor in ADR. In order for ADR to be successful, all involved should feel free to talk openly about the events surround the beneficiary’s care in order to work through any complaint or conflict. Both state and federal laws protect the confidentiality of most discussions in ADR.

How is ADR scheduled?
Once FMQAI has obtained a voluntary consent to participate from all involved, a convenient meeting date, time and place are arranged. The ADR meeting generally take 2 to 3 hours.

What is the cost?
Medicare provides this service at no charge to the participants.