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Independent Dispute Resolution

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ProPeer provides hospitals, health systems, and payors with independent arbiter services when disputed claims arise without resorting to litigation. The ProPeer system allows for a full review of all documentation quickly and efficiently without compromising quality in order to expedite the delivery of a resolution. ProPeer’s panel of clinical reviewers is comprised of over 1,100 board certified specialties and subspecialties nationwide allowing for seamless specialty-match.

ProPeer’s insight into the federally mandated independent dispute resolution process allows ProPeer to assist clients and partners in navigating the regulatory landscape while optimizing results. Our comprehensive suite of services spans both the formal dispute resolution process and informal three-party resolution.

Dispute Resolution Services For:

  • Pharmacy/Formulary Review
  • Medical Necessity/Appropriateness
  • Third Party Contract
  • Independent Dispute Resolution
  • Medical Dispute Resolution
  • Alternate Dispute Resolution
  • Health Benefit Coverage Dispute
  • Experimental & Investigational
  • Hospital Admission & Length of Stay
  • Diagnosis-related Group (DRG) Coding
  • Rescission
  • Behavioral Health Review

Trusted Solution for Dispute Resolution Services

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