How do you resolve differences between different providers and between payers and providers regarding level of care? Will a peer review process be used to resolve such differences?
It is the goal of the standards to provide the foundation for making consistent placement decisions throughout the substance abuse treatment delivery system based on objective criteria. Disparity may result due to individual interpretation of the criteria, especially those criteria more subjective in nature. It is believed that most differences can be resolved through open discussion between providers and payers. However, when agreement cannot be reached, particularly in regard to providers and payers, it may be necessary to request the opinion of and/or an appeal with an independent peer reviewer. Return to the top of the list.
Related Questions
- How do you resolve differences between different providers and between payers and providers regarding level of care? Will a peer review process be used to resolve such differences?
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