In the Federal Independent Dispute Resolution (IDR) process, parties are presented with an early and important choice: which IDR Entity (IDRE) will arbitrate the case. If the two parties fail to agree on a selection, the Centers for Medicaid and Medicare Services (CMS) will choose for them.
Trust and confidence in the entire process begins with this choice, so choosing a partner recognized for quality and independence is crucial.
Accreditation is a key marker of quality.
FHAS is the first and only organization to earn URAC’s IDR designation, which adds to our foundational Independent Review Organization (IRO) 6.0 Accreditation. We are proud to set the quality benchmark and meet the highest industry standards for dispute resolution under the No Surprises Act.
URAC designed this designation, as noted by Shawn Griffin, MD, President and CEO of URAC, to set “clear expectations for fairness, transparency and quality in how disputes are managed,” and went on to point out that the designation demonstrates leadership in “strengthening trust in health care.”
Trust Matters in Choosing an IDRE
The IDR arbitration is essentially a matter of fact-finding using information and data presented by two opposing parties. When parties can trust in the integrity of the IDRE, then the process operates as baseball-style arbitration should: a presentation of information and facts for assessment by a neutral arbitrator that must rule for one position or the other.
URAC accreditation establishes the basis for trust in FHAS. It demonstrates our adherence to rigorous standards of neutrality, transparency, and clinical review excellence in resolving payment disputes that arise from out-of-network medical billing.
As parties consider their choice of IDRE’s certified for the process, “We urge them to consider FHAS as a trusted, validated participant in the process – and one that offers the added value of consultative, educational services and feedback,” says Jim Bobeck, Esq., FHAS CEO. “We are ready and willing to meet with providers and health plans to evaluate their approach to IDR, help them understand their performance history, and strengthen their process going forward. If you have questions, we welcome your call.”
FHAS also offers a full discussion of considerations in selecting an IDRE in this previous blog post. As always, contact us here or reach out to your account representative with any questions, concerns or education needs.
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The information contained in this content piece is for general informational purposes only. While we strive to ensure the accuracy and completeness of the information presented, we make no representations or warranties of any kind, express or implied, about the accuracy, reliability, suitability, or availability with respect to the content or the information, products, services, or related graphics contained in the content piece for any purpose. Any reliance you place on such information is therefore strictly at your own risk. The content of this page is subject to change without notice. The information provided in this document does not constitute legal or other professional advice, and is non-binding upon FHAS and any federal government agencies.
