We use privacy-friendly, cookieless analytics (Plausible) plus one first-party cookie for anonymous visit counting — no advertising and no cross-site tracking. See our Cookie Policy and Privacy Policy.
No Surprises Act · Colorado
Dispute pathway: Federal IDR + state pathway
Out-of-network surgical and hospital-based claims in Colorado are routinely paid below the billed charge or denied outright. Under the No Surprises Act that payment is an opening offer, and dispute resolution exists to contest it. Sydra checks what qualifies, assembles the submission, holds every deadline, and can file it for you.
Federal IDR + state pathway
Colorado pays out-of-network providers the greater of 110% of the carrier's median in-network rate or the 60th percentile of the state's all-payer claims database, with unresolved disputes going to binding baseball-style arbitration (HB 19-1174, 2019; C.R.S. §10-16-704).
State-regulated plans follow Colorado's benchmark and arbitration. Self-funded ERISA plans follow the federal IDR process. Confirm routing by plan type before filing.
There is a defined pathway between a payer's underpayment and a binding arbitrated amount — an open negotiation window, an eligibility determination, a batching decision, then arbitration. Each step has a hard deadline, and missing one forfeits the claim. Providers win roughly 88% of federal IDR determinations they contest. Sydra is a flat, predictable fee — less than half of what most contingency firms charge. We file it, you keep the recovery.
Return to the Federal IDR hub.
No outcome is guaranteed. Results vary by claim, payer, specialty, and documentation. State routing depends on plan type; confirm against the CMS applicability chart before filing. This is general information, not legal or financial advice.
Medically & clinically reviewed by Dr. John M. Abrahams, MD
Board-certified neurosurgeon and founder of Sydra · Last reviewed September 2026 · About the author
Figures reflect the published federal record across all disputes, not a prediction about any individual claim. This is general information, not legal or financial advice.