Answers / IDR entity selection
How certified IDR entity selection works in the federal portal
After the Notice of IDR Initiation is filed, the parties have 3 business days to jointly select a certified IDR entity to arbitrate the dispute. If they cannot agree, CMS assigns one that is free of conflicts. The entity charges a fee of a few hundred dollars per dispute, set within government-approved ranges, paid by both sides and refunded to the winner.
The 3 business day window
Selection is the first thing that happens after a No Surprises Act dispute is initiated. The initiating party proposes a certified IDR entity in the Notice of IDR Initiation, and the other side can agree or object within 3 business days. Agreement is the exception: in practice, payers and providers rarely agree on an arbitrator, and the window passes.
Random assignment
When the parties do not agree, CMS selects a certified IDR entity at random from the entities that are eligible to take the dispute and free of conflicts of interest. Entities must attest that they have no relationship with either party. Either side can object to an entity on conflict grounds, which is rare but available.
Who the IDR entities are
Certified IDR entities are the arbitrators of the federal process, private organizations certified by the government to decide disputes. The largest by published volume include FHAS, C2C Innovative Solutions, and Medical Evaluators of Texas. They are referees, not advocates: you do not hire an IDR entity, you get one. Companies that file and argue disputes for providers are a different thing entirely.
Does it matter which entity you get?
The published record shows outcomes vary across entities, which is visible in the dispute-level data at idrexplorer.com. But across all 3.39 million published disputes for 2023 through 2025, providers won 85.8 percent of decisions. A well-built offer with the right evidence wins in front of any certified entity, because the arbitrator must pick one of the two offers and may not consider billed charges or government program rates, only the qualifying payment amount and the statutory factors.
Win in front of any arbitrator
Lido IDR builds offers from the published federal record, the evidence certified IDR entities actually weigh, and files for a flat fee per arbitration. Talk to an IDR specialist.