List of certified organizations

List of certified independent dispute resolution entities

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

Starting January 1, 2022, if a provider or facility and a health plan can’t 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.

The application process opened September 30, 2021, and will remain open to accept applications on a rolling basis. The list will be updated as additional organizations become certified.

Legal Business Name                                    Application ID     Website                                               Flat Fee
(single determinations)
Batched Fee
(batched determinations)
Certified for the following states    

C2C Innovative Solutions, Inc.

IDREApp-067

https://www.c2cinc.com 

$299

$670

All states in which the federal process applies

EdiPhy Advisors, L.L.C. IDREApp-115 https://www.medmanagementllc.com/ $500 $670 All states in which the federal process applies

Federal Hearings and Appeals Services, Inc.

IDREApp-107

https://www.fhas.com

$365

$450

All states in which the federal process applies

Island Peer Review Organization

DBA: IPRO

IDREApp-066

https://ipro.org/

$500

$670

All states in which the federal process applies

Keystone Peer Review Organization, Inc.

IDREApp-113

https://www.kepro.com/

$398

$670

All states in which the federal process applies

Maximus Federal Services, Inc.

IDREApp-114

https://maximus.com/federal

$375

$475

All states in which the federal process applies

MCMC Services, LLC

IDREApp-108

https://www.mcmcllc.com/

$395

$660

All states in which the federal process applies

Medical Evaluators of Texas

DBA: MET Healthcare Solutions

IDREApp-116

https://www.met-hcs.com

$350

$550

All states in which the federal process applies

National Medical Reviews

DBA: National Medical Reviews, Inc.

IDREApp-070

https://nationalmedicalreviews.com/

 

$285

$570

All states in which the federal process applies

Network Medical Review Company

DBA: Network Medical Review Company, Ltd.

IDREApp-071

https://www.nmrco.com

$397

$655

All states in which the federal process applies

Not accepting new disputes at this time

ProPeer Resources, LLC

IDREApp-110

https://www.propeer.com/

$450

$600

All states in which the federal process applies

 

Page Last Modified:
09/13/2022 04:36 PM