How to Utilize IDR

Five steps

1. Find eligible claims. Identify out-of-network claims that fall under the No Surprises Act and track the initial payment or denial date; the deadlines run from there.
2. Benchmark before you file. Use the explorer to see how determinations have gone for your specialty, state, payers and codes, with the n behind each figure.
3. Negotiate first. Open negotiation is required and can resolve disputes without IDR fees.
4. Prepare your offer and support. Offers are compared against the QPA and other permitted information.
5. Track every deadline and payment. Missed deadlines can make a dispute ineligible; awarded amounts still need to be collected.

General information only, not legal advice. See IDR resources for a plain-English overview of the process.

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