No Surprises Act · Independent Dispute Resolution
Medio combines data intelligence, process automation, and workflow management to help healthcare providers navigate the full IDR lifecycle — from claim identification through arbitration and payment collection.
1.2M+
Disputes filed H1 2025
88%
Provider win rate
383–447%
Median award vs QPA
$844M
Admin costs H1 2025
Automatically screen claims for IDR eligibility under the No Surprises Act. Flag qualifying disputes and surface the highest-value opportunities.
Manage open negotiations, arbitration filings, evidence preparation, and deadlines in one place. Never miss a response window.
Track outcomes, measure win rates, and monitor recovered revenue. Use historical data to strengthen future filings.
The IDR process, end to end
Federal arbitration under the No Surprises Act runs through six stages, each governed by a strict, dispute-killing deadline. Here's how Medio carries a claim through all of them.
Step 01
Runs continuously
Out-of-network claims flow in from your EHR and are screened for No Surprises Act eligibility the moment they arrive — so qualifying disputes surface on their own instead of slipping past a deadline.
Provider · Medio
| Claim | Payer | Service date | POS | Eligibility |
|---|---|---|---|---|
| CLM-4471 | Aetna | Mar 14 | 23 | Eligible |
| CLM-4470 | Aetna | Mar 12 | 23 | Eligible |
| CLM-4472 | UnitedHealthcare | Mar 10 | 23 | Pending |
| CLM-4468 | Cigna | Mar 09 | 11 | Ineligible |
Imported automatically from your EHR · screened the moment they land.
Step 02
Within 30 business days of payment or denial
See exactly why a claim qualifies — NSA applicability, data completeness, time remaining — then group eligible claims with the same payer into a single dispute in one click.
Provider · Medio
IDR eligibility
EligibleBundle into dispute
Bundle 2 into disputeStep 03
30-business-day window
Send the formal notice and let Medio run the clock. Every offer, counteroffer, and message lands on one timeline, with the deadline counting down so the window never closes on you.
Provider · Payer
Open negotiation ends · due Apr 28
Activity
notice_sent
Notice of open negotiation sent to Aetna
note
Payer counteroffer logged · $1,940
Step 04
4 business days to file · 3 to select
When negotiation stalls, Medio files the IDR initiation on the CMS portal, captures the reference number, and tracks the IDR entity selection — back-to-back windows that disqualify the dispute if missed.
Provider · Payer · CMS
CMS reference #
IDR-2025-0094417
Dispute type
Emergency
IDR initiated
Apr 30
IDR entity
Forefront IDR
Step 05
10 business days to submit · 30 to decide
Both sides submit a single final offer with evidence, and the arbiter picks one — no splitting the difference. Medio assembles the packet and recommends the number most likely to win.
Provider · Payer · IDRE
Your offer
$4,820
Evidence packet · 6 exhibits
Payer offer
$1,940
Submitted Apr 10
Baseball-style · the arbiter picks one offer, no middle ground.
30 days to decideStep 06
Paid within 30 calendar days
The arbiter issues a binding decision and the losing party pays. Medio tracks the award to your account and escalates non-payment — closing the loop from claim to recovered cash.
Provider · Payer · IDRE
Determination
Provider wonAward
$4,820
+$2,880 over the payer's offer
IDR Revenue Calculator
Enter your specialty, out-of-network claim volume, and location. We’ll estimate the additional annual revenue you could recover by taking eligible claims through the federal IDR process.