Request for Dispute Resolution of Medical Issues and Medical Fees Forms
| Form Name | Request for Dispute Resolution of Medical Issues and Medical Fees |
| Form # | 440-2842 |
| Form Revision | 12/15 |
| Category | Forms » Medical/Health |
| Downloads | |
| Form State | Oregon |
| Language | English |
| State Description | Used by parties to request administrative review of disputes issues, including palliative care, medical rules violations, experimental treatment, appropriateness of medical treatment, managed care... |
| Claimwire Description | n/a |