Independent Dispute Resolution (IDR)
What is the No Surprises Act?
The No Surprises Act is a United States federal law designed to protect patients from unexpected medical bills, especially from out-of-network providers during emergency care or at in-network facilities. It was passed as part of the Consolidated Appropriations Act, 2021, and took effect on January 1, 2022.
What Problem Does It Address?
Before this law, patients could receive large “surprise bills” when:
- They went to an in-network hospital but were treated by an out-of-network doctor (like an anesthesiologist or radiologist).
- They received emergency care from an out-of-network provider.
- They were transported by out-of-network air ambulance services.
Key Protections: Emergency Services
Patients cannot be charged more than in-network cost-sharing (copays, coinsurance, deductibles).
Prior authorization generally cannot be required for emergency care.
History of IDR
Independent Dispute Resolution (IDR), established under the No Surprises Act, provides a structured federal process to resolve payment disputes between providers, facilities, and health plans when negotiations do not reach an agreement. The process promotes fairness and transparency while protecting patients from balance billing and removing them entirely from payment disputes.
When a case enters IDR, a certified Independent Dispute Resolution Entity (IDRE) serves as a neutral decision-maker. Each party submits a proposed payment amount and supporting documentation, and the IDRE selects one offer based on federally defined criteria, including the Qualifying Payment Amount (QPA) and other regulatory factors.
North Haven – Federal IDR Expertise You Can Trust
North Haven is a certified Independent Dispute Resolution Entity through the U.S. Department of Health and Human Services, the Department of Labor, and the Department of the Treasury. We are authorized to administer the Federal IDR process for disputes between out-of-network providers, facilities, and providers of air ambulance services and group health plans, health insurance issuers in the group and individual markets, and Federal Employees Health Benefits (FEHB) carriers.
Through disciplined review processes, deep regulatory expertise, and efficient, timely delivery, North Haven ensures disputes are managed accurately, fairly, and in full alignment with federal standards.
When complexity arises, organizations need clarity and confidence. Dane Street delivers both.
Federal Independent Dispute Resolution (IDR) Resources
For additional guidance on the Federal Independent Dispute Resolution (IDR) process, the following official CMS resources provide helpful overviews, user guides, and reference materials for disputing parties.
CMS Guidance & Reference Materials
- Overview of Rules & Fact Sheets
- Federal Independent Dispute Resolution (IDR) Process Guidance for Disputing Parties
- Notice of IDR Initiation Web Form User Guide
- Certified IDR Entity Selection Form Job Aid
- IDR Notice of Offer Web Form Job Aid
- IDR Initiation – Resubmission Web Form User Guide
Administrative Fee:
Each party involved in a dispute must pay a non-refundable administrative fee to participate in the federal IDR process. For 2026, this fee is $115 per party per dispute. (Administrative fees are due from both parties no later than the time of offer submission)
IDR Entity Fees:
Access the Federal IDR Portal for case submissions and process management.
Please refer to the Overview of Rules & Fact Sheets for current applicable fee information.
Single Determination
$595
Batched Determination
$695
Tiered Determination
$110
CMS No Surprises Act Support
Federal IDR & No Surprises Act Resources
For questions regarding the No Surprises Act, or for additional information about its provisions, please visit the official Centers for Medicare & Medicaid Services (CMS) resource page at: https://www.cms.gov/nosurprises.
No Surprises Help Desk: 1-800-985-3059
For inquiries specifically related to the Federal Independent Dispute Resolution (IDR) process, or to initiate a dispute, please contact CMS directly at:
FederalIDRQuestions@cms.hhs.gov
Please note that inquiries related to the Federal IDR process must be directed to CMS using the contact information above and should not be submitted through North Haven communication channels.
Contact Our IDR Team
Have questions or need assistance with Independent Dispute Resolution (IDR) services? Please reach out directly to our dedicated IDR team at idr@danestreet.com.
All inquiries sent to this inbox are handled promptly by our experienced team to ensure efficient and accurate support. We are committed to responding in a timely manner and providing the guidance you need.
Contact us today to learn more about our IDR services.
to learn more about our IDR services.