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Resources & guides
Federal IDR, in plain English
Practical guides to the No Surprises Act and federal Independent Dispute Resolution — how the process works, what qualifies a claim, what the federal record actually shows, and when you need a lawyer. Reviewed by a practicing surgeon who files these claims.
Data
Win-rate benchmarks
Provider win rates overall (~85%) and by specialty, from the 2025 CMS Federal IDR data (~2.18M determinations).
Data
Win rates by payer
Provider win rates against UnitedHealthcare, Aetna, Cigna, BCBS and more — computed from the 2025 CMS data.
Data
Win rates by specialty
Provider win rates by specialty — radiology, emergency medicine, anesthesia, surgery — from the 2025 CMS data.
Reference
IDR glossary
Plain-English definitions of the No Surprises Act and federal IDR terms — QPA, open negotiation, batching, and more.
How the federal IDR process works.
Open negotiation to determination, step by step.
The full federal IDR sequence for surgical billing teams, from the open negotiation notice to the arbitrator's final determination.
Read the guide →IDR eligibility, deadlines, and fees.
What qualifies a claim, and what disqualifies one.
Eligibility rules, the business day deadline sequence, the fee structure, and the batching rules that decide whether a claim survives arbitration.
Read the guide →What the federal record shows.
Win rates, award multiples, and what happens after the determination.
Provider win rates, how awards compare to the QPA, what happens after a determination, and your recourse when a plan does not pay.
Read the guide →Do you need an attorney to file federal IDR?
Who can file, when legal help is worth paying for, and how the economics compare.
Whether an attorney is required, who can run IDR, and how a typical contingency compares to software your team operates in house.
Read the guide →The No Surprises Act, explained for surgeons.
QPA, open negotiation, and what IDR means for your practice.
A plain explanation of the No Surprises Act from the provider side: underpayment, the QPA, open negotiation, and how IDR works.
Read the guide →The federal IDR record, in one place.
Published win rates and award multiples, with the source and reporting period on every figure.
One standalone reference for federal IDR outcomes: win rates, award multiples over the QPA, and dispute volume, each figure sourced and dated.
Read the guide →How to file a federal IDR dispute.
Open negotiation to determination — the exact steps and the clock.
The exact sequence to take an out-of-network claim through federal IDR — with the deadline that governs each step.
Read the guide →Winning federal IDR against UnitedHealthcare.
Why UnitedHealthcare out-of-network disputes arise and how to build a winning IDR offer.
How to approach federal IDR disputes with UnitedHealthcare — from why they arise to the offer and evidence that win.
Read the guide →Winning federal IDR against Aetna.
Why Aetna out-of-network disputes arise and how to build a winning IDR offer.
How to approach federal IDR disputes with Aetna — from why they arise to the offer and evidence that win.
Read the guide →Winning federal IDR against Cigna.
Why Cigna out-of-network disputes arise and how to build a winning IDR offer.
How to approach federal IDR disputes with Cigna — from why they arise to the offer and evidence that win.
Read the guide →