Learn: the No Surprises Act and Federal IDR

Plain-English guides to the rules behind the data on this site, with links to the statutes, regulations and agency pages they summarize.

• The No Surprises Act, in plain English
  How the No Surprises Act protects patients from surprise out-of-network bills and how out-of-network payment is settled between providers and health plans.
• How Federal IDR works, step by step
  The Federal independent dispute resolution (IDR) process from initial payment through open negotiation, initiation, offers, decision and payment, with deadlines and sources.
• What is the qualifying payment amount (QPA)?
  What the qualifying payment amount (QPA) is, how health plans calculate it, and how it is used in Federal IDR and on this site.
• Which services and specialties are covered?
  Which out-of-network services the No Surprises Act and Federal IDR cover, which specialties appear most, and what is excluded.
• State surprise billing laws and Federal IDR (including Texas)
  When a state surprise billing law, not Federal IDR, sets out-of-network payment, with a detailed look at Texas.
• Federal IDR glossary
  Plain-English definitions of No Surprises Act and Federal IDR terms, from QPA and open negotiation to batching and default decisions.

General information, not legal advice. Rules change; check the cited sources. Last reviewed 2026-10-19.