What is the deadline to initiate a dispute in the portal?

The Notice of IDR Initiation is due within 4 business days after the 30 business day open negotiation period closes. It is the tightest window in the entire No Surprises Act process.

What information do I need to file?

The parties and contacts, the items and services in dispute with dates and codes, the qualifying payment amount from the payer's disclosures, and an attestation of eligibility. Batched disputes also need to show the same payer and same or similar services within a 30 business day window.

What if the payer never responds to the filing?

The process moves anyway. If the parties do not jointly select a certified IDR entity within 3 business days, CMS assigns one, and the arbitration proceeds on the same deadlines whether or not the payer engages.

Answers / How to file

How to file in the federal IDR portal, step by step

Filing means submitting a Notice of IDR Initiation at nsa-idr.cms.gov/paymentdisputes within 4 business days after your 30 business day open negotiation period ends. You will need the claim details, the payer's qualifying payment amount, both parties' contact information, and an attestation that the claim is eligible under the No Surprises Act.

Step zero: open negotiation

You cannot file anything in the portal until open negotiation has run its course. Within 30 business days of the payer's initial payment or notice of denial, you send the standard open negotiation notice to the payer. That opens a 30 business day negotiation window. Most payers never respond, and that is fine: the window closing is what lets you file. CMS has finalized changes that move this step into the federal IDR portal itself as the new process phases in.

Starting the dispute

Within 4 business days of the negotiation window closing, you submit the Notice of IDR Initiation in the portal. The form asks for the parties and their contacts, the items and services in dispute with dates and service codes, the qualifying payment amount the payer disclosed, and your attestation that the claim qualifies: emergency services, or out-of-network care at an in-network hospital or ambulatory surgery center. If you are batching, every line must be the same payer and same or similar services, all within a 30 business day window.

Selecting the arbitrator

Both sides have 3 business days to agree on a certified IDR entity. If they cannot, CMS assigns one at random. Either way, each party then pays the $15 administrative fee and the entity's deposit, a few hundred dollars set within government-approved ranges, refunded to whichever side wins.

Offers, evidence, decision

Within 10 business days of entity selection, each side submits one payment offer with supporting evidence. This is the whole case. The arbitrator must pick one offer or the other, weighing the qualifying payment amount along with training and experience, patient acuity and case complexity, market share, scope of services, and prior contracting history. The arbitrator may not consider billed charges or government program rates. The decision is due 30 business days after selection and is binding; the payer must pay within 30 calendar days.

The published record for 2023 through 2025 shows what happens when providers get this right: an 85.8 percent provider win rate, a median award around 4.7 times the qualifying payment amount, and a median of 37 days to decision.

Common filing mistakes

Four mistakes account for most dead claims. Missing the 4 business day initiation window after negotiation closes. Filing claims that have no No Surprises Act door, like office visits or government program claims. Batching claims that do not share a payer and same or similar services. And accepting the payer's qualifying payment amount at face value without checking the required disclosures. All four happen before the arbitrator ever sees the case.

File on time, every time

Lido IDR tracks every eligible claim from adjudication, batches what belongs together, and files in the federal portal before the windows close, for a flat fee per arbitration. Talk to an IDR specialist.