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  • About Independent Dispute Resolution | CMS
    Disputing parties have the option to choose a third-party entity, known as a certified IDR entity, from a list of certified organizations to resolve their dispute Everyone involved must attest to having no conflicts of interest
  • Non Emergency Services Independent Dispute Resolution Process
    The law requires the DMHC to conduct an independent dispute resolution process (AB 72 IDRP) that allows a noncontracting provider or payor to dispute whether payment of the specified rate was appropriate
  • Chart Regarding Applicability of the Federal Independent Dispute . . .
    there are six states that allow self- insured plans to opt into an SSL: Georgia, Maine, Nevada, New Jersey, Virginia, and Washington Please note that because opting into a state’s process is not mandatory, any given self-insured plan in the state may or may not have opted in
  • Out-of-Network Payment Process Under the No Surprises Act
    First, check CMS’ Chart for Determining the Applicability for the Federal Independent Dispute Resolution (IDR) Process (for ERISA plans, federal IDR will generally apply in all states, except where specified state law permits ERISA plans to opt in)
  • List of certified independent dispute resolution entities
    Each certified IDR entity has been certified to operate in every state in which the Federal IDR process applies The list will be updated as additional organizations become certified Learn more about the certification process
  • Basic State - Territory IDR Deeming Chart - Centers for Medicare . . .
    There are six states that allow self-insured plans to opt into an SSL: Georgia, Maine, Nevada, New Jersey, Virginia, and Washington Please note that because opting into a state’s process is not mandatory, any given self-insured plan in the state may or may not have opted in
  • Federal IDR Process Overhaul Finalized: What Stakeholders Need to Know
    The U S Departments of the Treasury, Labor, and Health and Human Services (HHS), together with the U S Office of Personnel Management, issued a final rule lowering the federal Independent Dispute Resolution (IDR) fee from $115 to $15 per party per dispute, reducing cost barriers for providers This fee is separate from the certified Independent Dispute Resolution Entity (IDRE) fee The final
  • Independent Dispute Resolution: Process, Costs, and Rules
    Learn how the Independent Dispute Resolution process works, who qualifies, what it costs, and how IDR entities decide between competing payment offers
  • Independent Dispute Resolution Designation - URAC
    URAC standards align with the Federal (and State, if applicable) independent dispute resolution processes In some State jurisdictions, accreditation may be an alternative to, or a substitute for, state oversight requirements for dispute resolution
  • HHS Chart Summarizes Applicability of State and Other Surprise Billing . . .
    These resources include a “Chart for Determining the Applicability for the Federal Independent Dispute Resolution (IDR) Process ” This chart summarizes when a state or other IDR process applies instead of the federal IDR process





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