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Text of CMS Guidance for Selected Dispute Resolution Entities: Required Steps to Making a Payment Determination Under the Patient-Provider Dispute Resolution Process (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance] Dec. 22, 2021 25 pages. "The purpose of this document is to provide guidance to [Selected Dispute Resolution (SDR)] entities on various aspects of the [Patient-Provider Dispute Resolution (PPDR)] process. This document includes information about how uninsured (or self-pay) individuals may initiate the PPDR process and the general requirements of the PPDR Process. It also provides information about the selection process and criteria for SDR entities, the requirements SDR entities must follow when making payment determinations, guidance on confidentiality standards, record keeping requirements, the revocation of certification, as well as how parties should request an extension of time periods for extenuating circumstances." |
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