| 1. |
Alternative dispute
resolution can and should be used to resolve disputes over
health care coverage and access arising out of the
relationship between patients and private health plans and
managed care organizations.
|
| 2. |
Alternative dispute
resolution can and should be used to resolve disputes over
health care coverage and access arising out of the
relationship between health care providers and private
health plans and managed care organizations.
|
| 3. |
In disputes involving
patients, binding forms of dispute resolution [such as
arbitration] should only be used where the parties agree to
do so after a dispute arises.
|
| 4. |
It is essential that due
process protections be afforded to all participants in the
alternate dispute resolution process.
|
| 5. |
Review of managed health
care decisions through alternative dispute resolution
complements the concept of internal review of determinations
made by private managed health care organizations.
|