Alternative dispute resolution (ADR) review process

Managed care organizations (MCOs) must have a medical dispute resolution process that includes one level of review. The MCO’s dispute resolution process must:

• Contain a peer review by an individual(s) licensed pursuant to the same section of the Ohio Revised Code as the health-care provider requesting the disputed issue;
• Be complete within 21 days of receiving written receipt of the dispute. MCOs must notify the parties involved in the dispute and their representatives of the decision in writing.