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Federal Independent Dispute Resolution (IDR) Process Guidance for Disputing Parties

Guidance to disputing parties (a health care provider, facility, or provider of air ambulance services, and a plan, issuer, or carrier) who are seeking to resolve a claim for payment for out-of-network health care items or services through the Federal independent dispute resolution Process. This guidance document is effective as of July 26, 2022 and applicable to all items and services furnished before October 25, 2022 for plan years (in the individual market, policy years) beginning on or after January 1, 2022 by an out-of-network provider subject to the Requirements Related to Surprise Billing; Part II, 86 FR 55980.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 07, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.