MC Arbitration

Overview

When arbitration is pursued in Review Representment or Pre-Arbitration Response Review, this flow is executed.  The system will first evaluate the dispute to determine if pre-arbitration was previously filed.  As shown in the excerpt below, pre-arbitration is not always a requirement for escalation to arbitration.

 

Arbitration Time Limits
  • Optional Pre-Arbitration disputes: within 45 days from the second presentment Central Site Business Date

  • All other disputes: within 75 days from the second presentment Central Site Business Date


If pre-arbitration was previous executed, the existing case will be escalated to arbitration.  If no pre-arbitration case exists, a new arbitration case will be filed.  Once case filing/escalation is complete, the dispute will move to the Arbitration Response while a response is awaited.

 

Review Arbitration

Rule(s)

MCExecuteArbitration

References