Alternative Dispute Resolution

TMF Health Quality Institute offers Alternative Dispute Resolution (ADR) as an option to resolve Medicare beneficiary complaints about the medical care they receive under the Medicare program. For beneficiary complaints that do not involve quality of care issues, voluntary and confidential ADR services may be offered.

There are three ADR options:

Mediation
Facilitated resolution
External resolution

ADR is used

To offer methods of efficiently and effectively resolving beneficiary complaints as alternatives to the traditional medical record review process.
To increase beneficiary satisfaction in both the process and the outcome when addressing complaints in the Medicare program.
To provide additional ways for providers to learn about the needs and concerns of Medicare beneficiaries in order to implement improvements in health care.

Cases are appropriate for ADR when there are no substantial quality of care concerns. TMF will determine suitability of the case for ADR based on issues such as the needs and interests of the beneficiary.