CERTIFIED FEDERAL IDR ENTITY
Impartial payment determinations under the No Surprises Act
medlitix is certified by the Departments of Health and Human Services, Labor, and the Treasury to resolve out-of-network payment disputes between providers and health plans — combining attorney-led determinations, physician clinical insight, and conflict-free review.
Why parties select medlitix
Credentials that verify
A certified federal IDR entity backed by URAC IRO accreditation and 40 state DOI accreditations — independence that regulators have already vetted.
Arbitration expertise, clinical depth
Determinations are made by attorneys trained in the federal IDR framework, with credentialed physicians engaged when a dispute turns on clinical questions.
Deadlines met, documented
Built to the forthcoming 5-business-day eligibility standard, with payment determinations issued within statutory windows.
Volume without shortcuts
60,000+ independent reviews completed annually across payer, provider, and government programs.
Built for batched disputes
Batched determinations handled at scale with transparent, published tiered pricing — no surprises in the fee, either.
A person, not a portal
Named points of contact, dispute-status communication, and education for teams navigating the federal IDR process.
IDR entity fee schedule
Certified IDR entity fees
Effective for disputes initiated on or after July 6, 2026| Single determination | $560 |
| Batched determination (up to 25 line items) | $795 |
| Each additional increment of 25 line items | +$135 |
Certified IDR entity fees are collected from both parties and refunded to the prevailing party in accordance with federal IDR rules. A separate, non-refundable administrative fee, set by the Departments, applies to each party — see the CMS No Surprises Act site for the current amount.
How the federal IDR process works
Comprehensive IDR support
IDR resource center
More topics
- The 2026 Operations final rule, explained
- Batching vs. bundling: getting it right
- Strengthening your IDR submission
- The cooling-off period after a determination
Working with medlitix
- Fee payment guide · Make a payment
- idr@medlitix.org · Request a meeting
Impartiality you can verify
Federal certification disclosure
The Departments of Health and Human Services, Labor, and the Treasury have certified medlitix as an independent dispute resolution (IDR) entity within the federal IDR process. In this role, medlitix resolves payment disputes between out-of-network providers, facilities, or providers of air ambulance services and group health plans, health insurance issuers, and Federal Employees Health Benefits (FEHB) carriers. Certified IDRE # IDREApp-193.
CMS certified entity list · cms.gov/nosurprises · Federal IDR process questions: FederalIDRQuestions@cms.hhs.gov
Latest IDR updates
All updates →Ready to assign a dispute to medlitix?
Select medlitix in the federal IDR portal, or reach our IDR team directly to discuss a dispute, batching, or fees.
Contact the IDR teamFrequently asked questions
What makes a dispute eligible for the federal IDR process?
The federal IDR process applies to out-of-network payment disputes covered by the No Surprises Act — generally emergency services, certain non-emergency services at in-network facilities, and air ambulance services — where no specified state law or All-Payer Model Agreement determines the rate. Parties must first complete the 30-business-day open negotiation period, then initiate through the federal IDR portal within 4 business days after it ends. medlitix verifies these requirements promptly upon final selection, to our 5-business-day service standard.
How quickly does medlitix determine eligibility?
Our service standard is 5 business days from final IDRE selection — the timeline the 2026 IDR Operations final rule will require once its portal provisions take effect. If additional information is needed, parties have 5 business days to respond to our request; both parties and the Departments are notified of the eligibility outcome.
How are batched disputes priced and reviewed?
Batched determinations are billed at our published batched fee of $795, which covers up to 25 line items, plus a fixed fee of $135 for each additional increment of 25 line items. Batched items must meet the federal batching criteria — medlitix reviews batching validity as part of eligibility, and our resource center guide on batching vs. bundling covers the most common errors.
How does medlitix screen for conflicts of interest?
Before accepting any selection, medlitix attests to meeting the federal conflict-of-interest requirements for that specific dispute, within the required attestation window. If we cannot attest — for example, due to a relationship with a party — we notify the Departments and do not participate in the dispute.
What fees do disputing parties pay?
Both parties pay the certified IDR entity fee shown in our fee schedule, and the prevailing party's fee is refunded in accordance with federal rules. Separately, each party pays a non-refundable administrative fee set by the Departments; the current amount is published on the CMS No Surprises Act site.