Dispute Resolution Process

The Dispute Resolution Process is available to any injured worker, employer, participating provider, or insurance carrier who may have an issue relating to medical care, including a request for a change of physician within the CWMP network. The Dispute Resolution Procedure must be pursued and completed in accordance with Title 85A of the Oklahoma Statutes, Section 56(A).

When a Certified Workplace Medical Plan’s office receives notice of a dispute, a resolution will be offered within ten (10) days. The ten-day time frame may be extended if necessary to gather further medical information relating to the dispute. If an extension is necessary, a written notice will be sent to all parties.

The Dispute Resolution Process consists of up to four (4) possible steps:

  1. If you have a dispute related to medical care, please complete the CWMP Dispute Resolution Form and fax to CompCHOICE at 405-841-9364.
  2. Upon receipt of a completed Dispute Form, the Certified Workplace Medical Plan will attempt to resolve the dispute administratively. If the issue can be resolved administratively by CompCHOICE, a letter is sent to all applicable parties.
  3. If the Certified Workplace Medical Plan is unable to resolve the dispute, it will be referred to the Medical Director for determination. If resolution is achieved, a letter is sent to all applicable parties.
  4. If the Medical Director feels additional expertise is required to resolve the matter, the Dispute Form and all available medical information pertaining to the issue, will be sent to either a specialist or a panel of healthcare providers at the Medical Director’s discretion. Then, a letter is sent to all applicable parties.