What does IDR arbitration cost?

Three layers. CMS charges each party a $15 administrative fee per dispute. The certified IDR entity charges a fee that both sides deposit up front and the winner gets refunded, so the loser funds the arbitration. The third layer is whoever files for you: most IDR vendors and law firms charge 15 to 25 percent of the recovery, while Lido IDR charges a flat fee per arbitration.

Who pays the arbitrator's fee in IDR arbitration?

Both parties deposit the certified IDR entity's fee when the dispute is set up. After the decision, the winner's deposit is refunded and the loser's deposit pays the arbitrator. With providers winning 85.8 percent of decided disputes in the published record, the expected cost of this layer is low for a well-selected claim.

How does batching change IDR arbitration costs?

Federal rules allow claims against the same payer for the same or similar services within a 30 business day window to be combined into a single dispute. One arbitrator decides the batch for one set of fees, and the $15 administrative fee is per party per dispute, not per claim. Batching is what makes small out-of-network claims economical to arbitrate.

Answers / Fees

IDR arbitration fees: what the process actually costs

The government's share is $15. The arbitrator is funded by the loser. The real variable is who files for you. IDR arbitration under the No Surprises Act has three layers of cost: a $15 federal administrative fee per party per dispute, a certified IDR entity fee that both sides deposit and the winner gets refunded, and the fee charged by whoever runs the process for you. That last layer ranges from 15 to 25 percent of the recovery at most vendors and law firms to a flat fee per arbitration at Lido IDR, which runs this site.

Layer one: the federal administrative fee

CMS charges each party $15 per dispute to use the federal portal. That is per dispute, not per claim, which matters because of batching: claims against the same payer for the same or similar services within a 30 business day window can be combined into one dispute. A batch of a dozen underpaid claims still costs $15 to administer.

Layer two: the arbitrator's deposit

The certified IDR entity, the arbitrator, sets its own fee within ranges the government approves. Both parties deposit it when the entity is selected. After the decision, the winner's deposit comes back and the loser's deposit pays the arbitrator. Two consequences:

A won dispute costs the provider $15 plus the filer's fee. The deposit round-trips.
The payer funds the arbitration in most decided disputes, because providers won 85.8 percent of them in the published record.

Layer three: the filer, where the real money is

Most groups do not run IDR arbitration themselves. The vendors and law firms that run it for them usually charge a contingency of 15 to 25 percent of the recovery. The published record shows the typical award running about 4.7 times the qualifying payment amount, so the contingency cut is routinely thousands of dollars per dispute: on a $50,000 recovery, 15 to 25 percent is $7,500 to $12,500.

Contingency pricing has one honest advantage: a lost dispute costs you nothing. At an 85.8 percent provider win rate, that insurance is worth less than it sounds, which is why Lido IDR prices the work the way the work actually scales: a flat fee per arbitration, quoted for your claim volume, with the award entirely yours. The percentage never comes out of a spine case or a trauma activation again.

What losing costs

Worth stating plainly: if your offer is not selected, you are out the $15 administrative fee, the entity deposit, and whatever your filer charges on a loss. This is why claim selection is most of the job. The disputes that lose tend to be the ones that should not have been filed or were filed late, not strong claims that drew a harsh arbitrator. How the winning side actually wins is covered in who wins IDR arbitration, and the deadlines that decide filed-late are in the timeline guide.

Paying a percentage today?

Bring your current arrangement and three months of out-of-network claims to a 30 minute call. We will show you what the same volume looks like at a flat fee per arbitration. Talk to an IDR specialist.