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.
Please note: These fees are effective for all disputes initiated on or after January 22, 2024.
| Legal Business Name & Website | Application ID | Fixed Fee (single determinations) | Fixed Batched Fee (for 2-25 line items in a batched dispute) | Fixed Tiered Fee (for every additional 25 line items in a batched dispute, beginning with the 26th line) |
|---|---|---|---|---|
| C2C Innovative Solutions, Inc. | IDREApp-067 | $595 | $795 | $200 |
| EdiPhy Advisors, LLC | IDREApp-115 | $800 | $1,150 | $250 |
| Federal Hearings and Appeals Services, Inc. | IDREApp-107 | $395 | $490 | $75 |
| iMPROve Health | IDREApp-151 | $620 | $850 | $100 |
| Island Peer Review Organization (DBA: IPRO) | IDREApp-066 | $740 | $1,075 | $200 |
| Keystone Peer Review Organization, Inc. (Not accepting new disputes at this time) | IDREApp-113 | $600 | $800 | $100 |
| Maximus Federal Services, Inc. | IDREApp-114 | $650 | $950 | $100 |
| MCMC Services, LLC | IDREApp-108 | $395 | $660 | $75 |
| Medical Evaluators of Texas (DBA: MET Healthcare Solutions) (Not accepting new disputes at this time) | IDREApp-116 | $375 | $575 | $100 |
| National Medical Reviews (DBA: National Medical Reviews, Inc.) | IDREApp-070 | $390 | $490 | $80 |
| Network Medical Review Company (DBA: Network Medical Review Company, Ltd.) | IDREApp-071 | $397 | $655 | $75 |
| ProPeer Resources, LLC | IDREApp-110 | $640 | $1,170 | $200 |
| Provider Resources, Inc. | IDREApp-141 | $479 | $599 | $97 |
Page Last Modified:
11/12/2024 09:39 AM