List of certified organizations

List of certified independent dispute resolution entities

The Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (the Departments) have certified these organizations to serve as independent dispute resolution (IDR) entities in the Federal IDR process between providers, facilities and providers of air ambulance services and group health plans, health insurance issuers and Federal Employees Health Benefits (FEHB) Program carriers.

If a provider or facility and a health plan cannot agree on the payment amount for an out-of-network service covered by No Surprises rules, these organizations can be selected to make a payment determination. 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.

 

Legal Business Name & Website           Application ID  2024 Fixed Fee (single determinations) 2024 Fixed Batched Fee (for 2-25 line items in a batched dispute) 2024 Fixed Tiered Fee (for every additional 25 line items in a batched dispute, beginning with the 26th line)2025 Fixed Fee (single determinations)2025 Fixed Batched Fee (for 2-25 line items in a batched dispute) 2025 Fixed Tiered Fee (for every additional 25 line items within a batched dispute beginning with the 26th line)
C2C Innovative Solutions, Inc.IDREApp-067$595$795$200$575$775$175
EdiPhy Advisors, LLCIDREApp-115$800$1,150$250$800$1,150$250
Federal Hearings and Appeals Services, Inc.IDREApp-107$395$490$75$435$545$85
iMPROve HealthIDREApp-151$620$850$100$500$850$100
Island Peer Review Organization (DBA: IPRO)IDREApp-066$740$1,075$200$740$1,075$250
Keystone Peer Review Organization, Inc. (Not accepting new disputes at this time)IDREApp-113$600$800$100$600$800$100
Maximus Federal Services, Inc.IDREApp-114$650$950$100$495$750$100
MCMC Services, LLCIDREApp-108$395$660$75$388$660$75
Medical Evaluators of Texas (DBA: MET Healthcare Solutions) (Not accepting new disputes at this time)IDREApp-116$375$575$100$375$600$200
National Medical Reviews (DBA: National Medical Reviews, Inc.)IDREApp-070$390$490$80$425$525$90
Network Medical Review Company (DBA: Network Medical Review Company, Ltd.)IDREApp-071$397$655$75$389$655$75
ProPeer Resources, LLCIDREApp-110$640$1,170$200$600$800$175
Provider Resources, Inc.IDREApp-141$479$599$97$498$623$101

 

Page Last Modified:
12/27/2024 07:59 AM