Sydra is an AI-powered platform for the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process. It automates eligibility screening, evidence packaging, offer preparation, submission, and deadline tracking so providers, contingency firms, and RCM companies recover fair out-of-network payments.

Healthcare providers and provider groups, contingency firms pursuing out-of-network disputes, and revenue cycle management (RCM) companies that add NSA IDR to their services.

Do you file disputes for us, or is it self-service?

Both. Sydra offers full-service filing (we file for you), self-service (your team files with the software), or staff training. You can switch models at any time.

How much does Sydra cost?

Sydra is a flat, predictable fee — less than half of what most contingency firms charge (which typically take 20% or more of every recovery, indefinitely) — or you can license the software and run it yourself.

Is Sydra HIPAA compliant?

Yes. Protected health information is handled under a Business Associate Agreement (BAA).

What is the average provider win rate in federal IDR?

In 2025, providers prevailed in roughly 85% of federal IDR determinations across all specialties. Rates vary by specialty — about 87% for orthopedic, spine, and neurosurgery, ~86% for hospitals, ~85% for emergency medicine, ~84% for pathology and labs, and ~82% for anesthesia — based on the CMS Federal IDR Public Use Files.

How many federal IDR disputes are filed each year?

CMS reported approximately 2.18 million federal IDR determinations for calendar year 2025 — many multiples of what regulators originally projected.

How much do contingency IDR firms charge?

Contingency firms typically take 20–25% of every recovery, indefinitely. On roughly $1M recovered that is $200,000–$250,000. A flat-fee model such as Sydra runs the same book for about half that.

What changed in the No Surprises Act IDR process in 2026?

The June 2026 CMS Federal IDR Operations Final Rule cut the administrative fee from $115 to $15 per party per dispute (disputes initiated on or after June 11, 2026) and, from November 1, 2026, allows batching up to 50 related services in a single dispute — making many smaller claims worth pursuing.

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Data & benchmarks

Federal IDR win-rate benchmarks

How often providers win out-of-network disputes under the No Surprises Act — overall and by specialty. These figures are drawn from the public CMS Federal IDR Public Use Files for 2025 (about 2.18 million determinations), the same data Sydra is built on.

~85%

provider win rate, all specialties (2025)

2.18M

federal IDR determinations in 2025

$115 → $15

IDR filing fee, per party (June 2026 rule)

Provider win rate by specialty

Specialty	Win rate	Notes
All specialties (weighted)	~85%	Providers prevail in the large majority of determinations.
Orthopedic / spine / neurosurgery	~87%	Highest — surgical claims rarely lose.
Hospitals & facilities	~86%	Facility and observation claims.
Emergency medicine	~85%	The archetypal No Surprises Act claim.
Pathology & clinical labs	~84%	Hospital-based reads the patient never chose.
Anesthesia	~82%	Lowest of the major specialties — base-plus-time billing.

Weighted by decided line items, CMS Federal IDR Public Use Files, calendar year 2025. Figures are rounded; individual practices vary widely — many self-filing groups win far below these benchmarks.

The 2026–2027 changes

Lower fee. The IDR administrative fee dropped from $115 to $15 per party, per dispute (initiated on or after June 11, 2026) — smaller claims now pencil out.
Bigger batches. From November 1, 2026, up to 50 related services can be batched into one dispute.
Standardized payer codes. For items and services on or after January 1, 2027, payers must attach standardized CARC/RARC codes and their IDR registration number to every payment or denial.

Where does your practice stand?

If you're winning well below ~85%, the gap is almost always process — eligibility, deadlines, evidence, and offer justification — not the merits. Sydra shows you your win and default rates by payer and code, and closes the gap for a flat fee.

Calculate your savings →

Medically & clinically reviewed by Dr. John M. Abrahams, MD

Board-certified neurosurgeon and founder of Sydra · Last reviewed September 2026 · About the author

Sources

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.