IDR filing service: what it does, what it costs, how to choose one

This page is for the people who own that decision: surgeons and physician owners, emergency medicine groups, radiology and anesthesia practices, practice managers, and the RCM companies that bill for them. It covers what a filing service handles, how the two pricing models compare, and what to ask before you sign.

What a filing service handles

Federal IDR is a sequence of deadlines with an arbitration at the end. A filing service owns the whole sequence:

1. Eligibility screening. From your remittance data, it flags which out-of-network claims qualify under the No Surprises Act: emergency services, out-of-network care at in-network facilities, and air ambulance. It also sorts each claim onto the right track, federal or state, based on the patient's plan.
2. Open negotiation. The notice that starts negotiation must be sent within 30 business days of the payer's initial payment or denial, and the negotiation window itself runs 30 business days. Many disputes settle here, and a good service treats this stage as a real negotiation, not paperwork.
3. Portal filing. If negotiation fails, the provider has 4 business days to initiate the dispute in the federal portal. The service files it, selects or objects to the certified IDR entity, and batches claims against the same payer for the same or similar services within a 30 business day window into one dispute.
4. Offer strategy and the evidence packet. Each side submits one payment offer and the arbiter must pick one in full, not split the difference. The service sets the offer using benchmark data for your specialty and state, and writes the evidence packet that justifies it against the qualifying payment amount.
5. Fee handling. It pays and tracks the $15 per party administrative fee on each dispute and the certified IDR entity fee, which is refunded to the winning party. The losing party's entity fee is kept.
6. Decision and payment tracking. The median time from filing to decision is 37 days. After the decision, the payer owes payment within 30 calendar days. The service tracks that payment and escalates when it does not arrive.

The full stage-by-stage breakdown is in what does an IDR filing service do, and eligibility rules are in who can use federal IDR.

What it costs: two pricing models

Most filing services and law firms charge contingency: 15 to 25 percent of the recovery. The recovery is the dollars collected above the payer's initial payment, and the fee scales with it. On a $50,000 recovery, 15 to 25 percent is $7,500 to $12,500 in fees. The work of filing a dispute is roughly the same whether the award is large or small, which is why the contingency model gets expensive exactly when arbitration works.

The alternative is a flat fee. Lido IDR charges a flat fee per arbitration, quoted for your claim volume, with no percentage of the award. Every dollar of the award is yours. The flat fee model also changes the incentive: a contingency firm is paid most for the biggest awards, while a flat fee service is paid to file everything worth filing, including the small claims a contingency firm skips.

Both models sit on top of the same government fees: a $15 administrative fee per party per dispute, and the certified IDR entity fee that the losing party ultimately pays. The worked examples at $10,000 and $50,000 recoveries are in IDR filing service pricing.

The record a filing service works from

Providers win 85.8 percent of federal IDR disputes that reach a decision, the median award is 4.7 times the qualifying payment amount, and the median time from filing to decision is 37 days, based on 3.39 million disputes in the federal public use files.

All 3.39 million federal IDR disputes published by CMS, 2023 through 2025. Explore the data at idrexplorer.com.

Those numbers come from the CMS public use files, which publish every federal dispute. They matter for choosing a service because they are the baseline: a filing service claiming a high win rate should show you how its record compares to the published 85.8 percent, at the dispute level, for your specialty.

How to choose one

Three resources on this site do the comparison work:

• 10 questions to ask an IDR filing service: fee structure, who keeps the award, batching, win rate evidence, lock-in, and who pays fees on losses.
• Pricing models compared: flat fee per arbitration vs contingency, with worked examples.
• DIY IDR vs a filing service: an honest look at when self-filing is the right call.