Answers / By the numbers

Federal IDR by the numbers

The volume nobody predicted

When the No Surprises Act rules were finalized, the departments projected federal IDR would see roughly 22,000 disputes a year. The published record for 2023 through 2025 contains 3.39 million. Out-of-network specialists discovered that the forum built to backstop a billing ban was, in practice, a fast and favorable collections channel, and filing volume has grown every year the data covers.

Who wins, and by how much

Providers won 85.8 percent of decided disputes across the published record. The margin matters as much as the rate: the typical winning award came in around 4.7 times the qualifying payment amount, the payer-calculated benchmark that anchors the process. Arbitrators picking provider offers that often, at multiples of the payer's own number, is the clearest signal in the data that well-built provider offers beat QPA-anchored payer offers.

How fast it moves

The median published dispute took 37 days from arbitrator selection to decision. Add the open negotiation period and the filing windows and a typical claim resolves within a few months of the payer's payment or denial, with payment due 30 calendar days after the decision. Compare that to the years a network contract dispute or lawsuit takes and the appeal of the forum is obvious.

Who files

Published volume is dominated by the hospital-based and emergency specialties the No Surprises Act protects: emergency medicine above all, followed by radiology, anesthesiology, pathology, and the surgical specialties. A large share of volume moves through batched disputes, which combine claims against the same payer for the same or similar services within a 30 business day window into a single arbitration. The full record, sliceable by specialty, payer, and state, is at idrexplorer.com.