|
|
|
|||
|
The
QIO for |
|
|
||
|
|
|
|
||
|
Concerned about your healthcare treatment? Let’s talk. This fact sheet is designed to answer
basic questions about mediation. When you call Northeast Health Care Quality Foundation
to file a complaint, a review case manager will give you more details. If
your complaint is suited for mediation, the process will be further explained
to you. What
is mediation? Mediation is a new option to resolve a
quality of care complaint under Medicare. This is at no direct cost to you.
It is a dialogue between you and your
doctor or hospital, facilitated by an impartial third person (the mediator).
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. How
will I know if my complaint is appropriate for mediation? Not all complaints are appropriate for
mediation. A Northeast Health Care Quality Foundation physician reviewer
determines if the case is suitable to be resolved by both parties. What are the key features of a
mediation session? · The session is facilitated by a professional,
impartial third person (the mediator). · The session is usually conducted face-to-face but
can also be conducted over the telephone. It typically takes two to four
hours. · The session is strictly confidential. The
discussion is not documented and cannot be used in any legal proceedings. · You and your physician/provider determine the
solution to your complaint. Can
I bring someone with me to the mediation? Yes, if agreed to by the other party,
you may bring a family member or designated representative to the mediation.
You may also be provided with a mediation advisor, who is a trained
professional that can answer your questions about the mediation process. How
will mediation affect my relationship with my doctor or healthcare plan? Participants often report improved
relationships after the mediation session. If your doctor or provider agrees
to participate, he/she is also committed to improving communication. I
am interested in the mediation option, what do I do? Call Northeast Health Care Quality
Foundation at 1-800-772-1051. You will be directed to an individual who will
be able to walk you through the process that follows. Keep in mind that not
all complaints are suitable for mediation and you and your doctor or hospital
representative must agree to participate in mediation before moving forward. How
does mediation affect my benefits under Medicare? Participation is voluntary. If you
choose not to participate your benefits under Medicare are not affected. This
material was prepared by CMRI under contract with the Centers for Medicare
& Medicaid Services (CMS). The contents do not necessarily reflect CMS policy.
All or part of this material may be reproduced without consent, if credit is
given to CMRI. |
||||
|
For
more information on how mediation may be used to resolve your complaint, call
Northeast Health Care Quality Foundation 1-800-772-0151. |
||||
|
|
||||
|
Copyright © 2005 Northeast Health Care Quality Foundation, all rights
reserved |
||||
