Medicare Program Integrity Manual (Pub. 100-08), § 2.6

Dispute Resolution Process

Length: 202 wordsOfficial source
2.6-Dispute Resolution Process Disputes/issues will be escalated, if necessary, for resolution by the following process: 1. The SMRC and the UPIC counterparts will first attempt to resolve the issue. 2. If the SMRC and the UPIC counterparts are unable to come to a resolution, the matter will be brought to the attention of the SMRC JOA POC and the UPIC JOA POC (as identified in Appendix A, Master Contact List). 3. If the SMRC JOA POC and the UPIC JOA POC are unable to come to a resolution, the matter will be escalated to the SMRC PM and the UPIC Project Manager (as identified in Appendix A, Master Contact List). 4. If the SMRC PM and the UPIC Project Manager are unable to come to a resolution, the SMRC PM will bring this matter to the attention of the SMRC CMS COR and the UPIC Project Manager will bring this matter to the attention of the UPIC CMS COR (as identified in Appendix A, Master Contact List). 5. If the dispute between the SMRC and the UPIC cannot be resolved, the issues will be directed, in writing, to the CMS CORs and BFLs for resolution by a JOA Alternative Dispute Resolution Team.
Medicare Program Integrity Manual (Pub. 100-08), § 2.6: Dispute Resolution Process | Justis AI