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NO SURPRISES ACT · FEDERAL IDR PROCESS

# Understanding the Independent Dispute Resolution Process

CIDRE advances the integrity of the federal Independent Dispute Resolution process - supporting efficient, impartial administration that protects patients from surprise medical bills.

## [New Study Shows a More Comprehensive Picture of How the No Surprises Act IDR Program Protects Patients from Costly Surprise Medical Bills and Where the Program Stands Today](https://www.cidre.org/blog/new-study-shows-no-surprises-act-idr-program-protects-patients-from-costly-surprise-medical-bills?hsLang=en)

 07/24/2026

[Link to Study →](https://www.cidre.org/hubfs/20260720_IDR%20Program%20Performance_An%20Evidence-Based%20Review%20of%20Volume%20Eligibility%20and%20Payment%20Outcomes.pdf?hsLang=en) [READ MORE →](https://www.cidre.org/blog/new-study-shows-no-surprises-act-idr-program-protects-patients-from-costly-surprise-medical-bills?hsLang=en)

*"By  working with the IDR community, we strengthen the broader goal of the No Surprises framework — shielding patients from unexpected medical bills while objectively maintaining a functional healthcare payment system."*

## CIDRE MISSION STATEMENT

### 2M+ PER YEAR

Disputes via IDR 

### $0

Patient liability 

### 70%

Eligible Out of Network claims settled without IDR

ABOUT CIDRE

---

## Committed to a Balanced, Functional, and Independent IDR Process

CIDRE advocates for evidence-based, independent, and balanced policies that protect the integrity of the processes meant to shield patients from surprise medical billing. We educate lawmakers, regulators, and stakeholders on the operational realities and public value of the IDR system.

### Regulatory Stability

Promoting clarity so IDR entities operate efficiently and impartially.

### Process Independence

Defending the independence of dispute resolution from undue influence.

### Evidence-Based Policy

Maintaining the balance between providers, payers, and patients, and grounding debates in the facts.

### Stakeholder Education

Informing lawmakers on IDR operational realities and public value.

POLICY PRIORITIES

## Our Advocacy Focus

 View all priorities

 01

## Preserving and Strengthening the Role of IDR Entities

Certified IDR entities are foundational to the federal IDR process. CIDRE supports policies protecting their active role across eligibility, administration, and payment determinations. 

[READ MORE](https://www.cidre.org/policy-priorities?hsLang=en#idrentities)

HOW IT WORKS

## The IDR Process in Four Steps

1

## Open Negotiation

Providers and health plans enter a 30-business-day negotiation period.

2

## IDR Initiated

If unresolved, either party initiates the federal IDR process.

3

## IDRE Review

A certified neutral entity reviews offers against statutory criteria.

4

## Determination

The closest offer to criteria prevails. Patients remain fully protected.

## Get In Touch

Questions about CIDRE’s work or membership?  
We’d love to hear from you.

Mary Jane Rodes, Association Manager

[maryjane@rodesconsulting.com](mailto:maryjane@rodesconsulting.com)

2020 Pennsylvania Ave NW, Suite 511  
Washington, DC 20006

[Send a Message](mailto:maryjane@rodesconsulting.com)

© 2026 CIDRE, Inc. - Coalition for Independent Dispute Resolution Entities

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