The federal IDR portal: where it is and how to file
An independent guide to the government filing system for No Surprises Act payment disputes. Not a government site.
The federal IDR portal is where out-of-network payment disputes under the No Surprises Act actually get filed, and where most of them are won. This page covers which portal you need, what happens inside it, and the deadlines that decide whether your claim ever gets heard. Everything here comes from the published federal record and the portal itself.
All 3.39 million federal IDR disputes published by CMS, 2023 through 2025. Explore the data at idrexplorer.com.
The federal IDR portal is the CMS web system where providers and health plans file No Surprises Act payment disputes. The provider and payer portal is at nsa-idr.cms.gov/paymentdisputes. Filing starts with a Notice of IDR Initiation, due within 4 business days after the 30 business day open negotiation period ends. This site is an independent guide operated by Lido IDR, not a government website.
Which portal you need
There are two federal portals and they get mixed up constantly. The payment disputes portal at nsa-idr.cms.gov/paymentdisputes is for providers, facilities, and air ambulance companies disputing what a health plan paid on a protected out-of-network claim. That is the portal this site is about.
The patient-provider dispute portal at nsa-idr.cms.gov/billdisputes is different: it is where uninsured and self-pay patients dispute a bill that came in at least $400 over their good faith estimate. If you are a patient who got a surprise bill, that portal and the federal help desk at 1-800-985-3059 are your doors, not the payment disputes portal.
What happens inside the portal
Once you submit the Notice of IDR Initiation, the rest of the process follows fixed deadlines. The other party responds, and both sides have 3 business days to agree on a certified IDR entity, the arbitrator. If they cannot agree, CMS assigns one. Each side pays a $15 administrative fee per party per dispute, plus the IDR entity's fee, a deposit of a few hundred dollars set within government-approved ranges. The winner gets the entity fee refunded.
Then it is baseball-style arbitration: each side submits one payment offer with supporting evidence within 10 business days of the entity being selected. The arbitrator must pick one of the two offers, nothing in between, and issue a decision within 30 business days of selection. The decision is binding, and the losing payer must pay within 30 calendar days. Across all 3.39 million disputes published by CMS for 2023 through 2025, providers won 85.8 percent of decisions, and the median took 37 days.
Before you can file
The portal will not take a dispute cold. The No Surprises Act requires an open negotiation period first: you have 30 business days from the payer's initial payment or denial notice to send an open negotiation notice, and then the negotiation window runs 30 business days. Only after that window closes, and only within the next 4 business days, can you file the Notice of IDR Initiation in the portal.
CMS has finalized operational changes that move open negotiation itself into the federal IDR portal as the new process phases in, so expect the first step to happen inside the same system rather than over email. The deadlines do not get more forgiving, they just get more visible.
What the portal will not do for you
The portal is a filing system, not a claims operation. It does not watch your remittances for protected out-of-network claims, it does not calculate the 30 business day clocks that start long before any filing, it does not decide which claims can be batched together, and it does not build the evidence that wins offers. Most claims are lost to deadlines that run out before the portal ever sees them.
That is the part Lido IDR handles: tracking eligible claims from adjudication, batching them correctly, preparing offers from the published record, and filing on time, for a flat fee per arbitration instead of a percentage of what you win.
Common questions
Is the federal IDR portal a government website?
Yes. The federal IDR portal is run by CMS on behalf of the federal government at nsa-idr.cms.gov. This site, federalidrportal.com, is an independent guide operated by Lido IDR and is not affiliated with CMS or any government agency.
Where is the federal IDR portal?
The provider and payer payment disputes portal is at nsa-idr.cms.gov/paymentdisputes. The separate patient-provider dispute portal for uninsured and self-pay billing disputes is at nsa-idr.cms.gov/billdisputes.
What does it cost to file in the federal IDR portal?
Each party pays a $15 administrative fee per dispute, plus the certified IDR entity's fee, a deposit of a few hundred dollars set within government-approved ranges. The winning party gets the entity fee refunded, so a provider who wins is out only the $15.
What is the deadline to file in the portal?
The Notice of IDR Initiation is due within 4 business days after the 30 business day open negotiation period ends. Open negotiation itself must start within 30 business days of the payer's initial payment or denial. Miss either window and that dispute is gone. The full chain is on the deadlines page.
Can patients use the federal IDR portal?
Not the payment disputes portal, which is for providers and health plans. Uninsured and self-pay patients whose bill came in at least $400 over their good faith estimate use the patient-provider dispute portal at nsa-idr.cms.gov/billdisputes, or can call the No Surprises Act help desk at 1-800-985-3059.
Talk through your numbers
Book 30 minutes with an NSA/IDR specialist. Bring your payer mix and rough out-of-network claim volume, and we will walk through which claims are eligible, what similar providers are winning at IDR, and what a flat fee arrangement looks like. Three quick questions, then pick a time.
Which best describes you?
Roughly how many out-of-network claims does your group bill a month?
An estimate is fine.
Who works your out-of-network claims today?
Last step, then pick a time.
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This page is for medical providers
If you got a surprise medical bill, you do not need a service like ours. The federal No Surprises Act protects you directly, and government help is free.
Start here: cms.gov/medical-bill-rights
No Surprises Help Desk: 1-800-985-3059