Federal IDR (No Surprises Act dispute resolution)
The 'baseball arbitration' process between out-of-network providers and plans for NSA-covered services.
Federal IDR resolves payment disputes between out-of-network providers and health plans for NSA-covered services. After 30 business days of open negotiation, either party can initiate IDR. A certified IDR entity picks one of the two parties' final offers as the binding payment amount. Patients are NOT parties — their cost-sharing is fixed at in-network levels under NSA.
Frequently asked questions
What is federal idr (no surprises act dispute resolution)?
Federal IDR resolves payment disputes between out-of-network providers and health plans for NSA-covered services. After 30 business days of open negotiation, either party can initiate IDR. A certified IDR entity picks one of the two parties' final offers as the binding payment amount. Patients are NOT parties — their cost-sharing is fixed at in-network levels under NSA.
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