Independent Peer Review of
Health-Care Decisions
A health carrier or managed-care entity and an enrollee may agree on a peer to conduct an independent review of any adverse determination made by the health carrier or managed-care entity. If the parties are unable to agree on a peer to conduct the review, the health carrier or managed-care entity can forward the case file to an independent review organization designated by the Montana Department of Public Health and Human Services.
The department has designated the Mountain-Pacific Quality Health Foundation as the independent review organization. The contact at Mountain-Pacific Quality Health Foundation is:
Myrna Seno, RN
Private Review Manager
3404 Cooney Drive
Helena, MT 59602
406-443-4020
800-497-8232
406-443-8067 Fax
To learn more about independent peer review see:
Montana Code Annotated 33-37-101: Insurance & Insurance Companies, Regulation of Health Carriers and Managed Care Entities
Administrative Rules of Montana 37.108.301: Independent Review of Health Care Decisions
Or contact Pamela Sourbeer, Administrative Officer, QAD/Licensure Bureau, 406-444-9519.
Page last updated 01/22/2007
