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# FHAS

## Sitemaps
[XML Sitemap](https://www.fhas.com/sitemap_index.xml): Includes all crawlable and indexable pages.

## Posts
- [Trust FHAS for High-Quality, Timely Health Care Reviews—Company Earns NCQA Accreditation for Utilization Management](https://www.fhas.com/resources/industry-updates/fhas-ncqa-utilization-management-accreditation/): Federal Hearings and Appeals Services (FHAS) has earned three-year NCQA Utilization Management Accreditation, reinforcing our position as a trusted partner for health plans and government programs seeking fair, timely, and clinically sound healthcare determinations. 
- [FOR IMMEDIATE RELEASE: FHAS Earns NCQA Accreditation for Utilization Management](https://www.fhas.com/resources/industry-updates/for-immediate-release-fhas-earns-ncqa-accreditation-for-utilization-management/): Shows Commitment to Clinical Quality, Consistency, Compliance and Integrity 
- [Departments Issue Promised Guidance on Newly Required RARCs:  What Payers and Providers Need to Know ](https://www.fhas.com/resources/industry-updates/no-surprises-act-rarcs-what-payers-and-providers-need-to-know/): On July 17, 2026, the Departments of the Treasury, Labor, and Health and Human Services, together with the Office of Personnel Management, issued guidance specifying the remittance advice remark codes (No Surprises Act RARCs) that group health plans and health insurance issuers (payers) must use when communicating with out-of-network providers and facilities relating to claims subject to the No Surprises Act (NSA). 
- [Three IDR Provisions Take Effect August 3rd: What Parties Should Know](https://www.fhas.com/resources/industry-updates/three-idr-provisions-take-effect-august-3rd-what-parties-should-know/): The Federal Independent Dispute Resolution (IDR) Operations final rule reshapes how payers, providers, and certified IDR entities move disputes through the No Surprises Act process. Its changes phase in on a staggered timeline over the coming year, with the largest procedural updates tied to the forthcoming IDR Gateway portal. But three IDR provisions attach directly to the rule’s August 3, 2026 effective date — and parties should prepare to square them away now.
- [Are You Cool with the Cooling Off Period? If not, FHAS can help!](https://www.fhas.com/resources/industry-updates/idr-cooling-off-period-how-the-fhas-calculator-helps/): Anyone who has worked within the federal Independent Dispute Resolution process understands that accurate details and correct timing are critical to a fair outcome. But some of the rules, even under the new final rule, can be confusing. Take the cooling off period, which has long been a source of confusion and even frustration.  When does it start and end? How are initiation dates impacted? When does a cooling off period actually apply? 
- [Prior Authorization: What OIG’s Medicare Advantage Data Really Shows](https://www.fhas.com/resources/industry-updates/medicare-advantage-prior-authorization-denials-oig-findings/): Last week’s HHS Office of Inspector General reports on Medicare Advantage prior authorization denials dominated the headlines — in the Wall Street Journal, the New York Times, and across the trade press. The coverage focused, understandably, on the numbers: 65% of long-term acute care hospital (LTCH) requests denied. 54% of inpatient rehab facility (IRF) requests denied. A 95% appeal overturn rate for skilled nursing facility (SNF) denials. A plan reversing its own decisions at rates approaching 100%. 
- [The IDR Final Rule is Out: Now What?  ](https://www.fhas.com/resources/industry-updates/the-final-idr-rule-is-out-now-what/): The new Federal IDR final rule is a significant and positive step forward to improve the submission process, clarify the ambiguities, reduce gamesmanship in the system, and make it more accessible for parties to resolve claims.  
- [FHAS Statement on Final IDR Operations Rule](https://www.fhas.com/resources/industry-updates/fhas-statement-on-final-idr-operations-rule/): FHAS was pleased to note today that the much-anticipated Final IDR Operations Rule governing the federal Independent Dispute Resolution (IDR) program has received final approval from the Office of Management and Budget (OMB). We issued the following statement from James Bobeck, Esq., our Chief Executive Officer: 
- [As Prior Authorization Eases, Medicare’s History Offers Guidance for Payers and Providers ](https://www.fhas.com/resources/industry-updates/as-prior-authorization-eases-medicares-history-offers-guidance-for-payers-and-providers/): The current wave of prior authorization (PA) reform is real, significant — and, for those of us who have worked inside Medicare and commercial payment integrity for years, strikingly familiar. 
- [High-Performers in the IDR Process are Preparing for New Rules Today](https://www.fhas.com/resources/industry-updates/high-performers-are-preparing-for-the-idr-proposed-operations-rule/): The bipartisan No Surprises Act (NSA) has protected an estimated 50 million Americans from surprise medical bills and lowered their out-of-pocket medical expenses. Today, with patients removed from the middle, healthcare providers and payers depend on the Independent Dispute Resolution (IDR) process to settle and/or arbitrate payment disputes.  
- [Proposed Rule Includes Changes to Administrative Fees in IDR Process](https://www.fhas.com/resources/industry-updates/proposed-rule-includes-changes-to-administrative-fees-in-idr-process/): Looking to balance access and sustainability in the Federal Independent Dispute Resolution (IDR) To balance access and sustainability in the Federal Independent Dispute Resolution (IDR) process, the Proposed Operations Rule contemplates a significant series of changes throughout the process, including to the early communications and initiation process, open negotiations, and batching. In addition, the proposed rule includes many changes to the timing and remittance of administrative fees, as well as fee levels in certain situations.   
- [IDR Parties Should Confirm Process Compliance Today — Before Proposed Rule Adds New Requirements](https://www.fhas.com/resources/industry-updates/idr-parties-should-confirm-process-compliance-today-before-proposed-rule-adds-new-requirements/): Improving transparency and communication in the Federal Independent Dispute Resolution (IDR) process is an important goal of the Proposed Operations Rule, now undergoing its final review with the Office of Budget and Management.   
- [New Federal IDR Gateway is Coming: Here’s What You Need to Know](https://www.fhas.com/resources/industry-updates/new-federal-idr-gateway-is-coming-heres-what-you-need-to-know/): In March, The Centers for Medicare & Medicaid Services (CMS) announced that later this year the Federal Independent Dispute Resolution (IDR) process will transition to the new Federal "IDR Gateway.” The IDR Gateway is the portal discussed in the Proposed Operations Rule, and it will play a significant role in the future of the Federal IDR program.   
- [Inpatient Rehab: Medicare Coverage Depends on Documentation ](https://www.fhas.com/resources/industry-updates/inpatient-rehab-medicare-coverage-depends-on-documentation/): FHAS has observed a modest uptick in traditional Medicare denials related to inpatient rehab Medicare coverage, particularly for stays at inpatient rehabilitation facilities (IRFs). As a subcontractor to Qualified Independent Contractors (QICs), FHAS reviews traditional Medicare claim appeals at the second level of the appeals process.
- [IDR Proposed Rule:  Open Negotiation Is Not a Formality – It Matters. Proposed changes would drive genuine exchange of information](https://www.fhas.com/resources/industry-updates/idr-proposed-rule-open-negotiation-is-not-a-formality/): Earlier this year, the Federal IDR Proposed Rule moved one step closer to finalization when it entered its official review at the Office of Management and Budget (OMB) – the last stop on its review journey.  
- [Have Confidence in Your IDRE Choice: URAC Accreditation and IDR Designation Reflect FHAS’s Fair, Independent Reviews](https://www.fhas.com/resources/industry-updates/why-urac-accreditation-matters-in-choosing-an-idre/): 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. 
- [A Closer Look: How Proposed Rule Could Change and Clarify Batching](https://www.fhas.com/resources/industry-updates/a-closer-look-how-proposed-rule-could-change-and-clarify-batching/): As discussed in our recent blog, federal regulations governing the Independent Dispute Resolution (IDR) process could be finalized imminently, now that the Proposed Federal IDR Operations Rule is under review at the Office of Management and Budget (OMB).  
- [Common and Avoidable Ineligibility Errors: In IDR Filings, Details Matter](https://www.fhas.com/resources/industry-updates/common-and-avoidable-ineligibility-errors-in-idr-filings-details-matter/): Every dispute presented for Independent Dispute Resolution (IDR) must pass an eligibility review before proceeding into the full process set forth under the federal No Surprises Act. While the number of rejected disputes has been falling, a surprising number of filings are still found ineligible.  
- [The $10 Billion Correction: Understanding the New Rigor in Skin Substitute Reviews ](https://www.fhas.com/resources/industry-updates/the-10-billion-correction-understanding-the-new-rigor-in-skin-substitute-reviews/): The wound care industry is facing a massive regulatory correction. After years of explosive growth, the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have turned their focus toward skin substitutes — biological and synthetic materials used to treat chronic wounds. 
- [A Look at the 2025 H1 Federal IDR Data ](https://www.fhas.com/resources/industry-updates/a-look-at-the-2025-h1-federal-idr-data/): CMS recently released the Supplemental Background on the Federal IDR Public Use File (PUF) for the first half of 2025, and the data reflects a system achieving significant gains in throughput. 
- [The Power of Predictability: Why Fixed-Fee Models are the Future of Federal Contracting ](https://www.fhas.com/resources/industry-updates/the-power-of-predictability-why-fixed-fee-models-are-the-future-of-federal-contracting/): Government agencies are navigating a paradoxical reality: the increasing demand for tangible project outcomes coupled with resource constraints. As FHAS CEO Jim Bobeck noted in a recent interview, agencies today face "higher expectations and more scrutiny without a proportional increase in resources." 
- [Preparing for the 2026 Regulatory Shift: An Update on the Proposed Federal IDR Operations Rule ](https://www.fhas.com/resources/industry-updates/preparing-for-the-2026-regulatory-shift-an-update-on-the-proposed-federal-idr-operations-rule/): While some stakeholders anticipated the implementation of the Federal IDR Operations Rule in 2025, the focus has now moved to 2026 as the pivotal year for these changes. 
- [FHAS Becomes First Organization to Receive URAC Designation in Independent Dispute Resolution](https://www.fhas.com/resources/industry-updates/fhas-becomes-first-organization-to-receive-urac-designation-in-independent-dispute-resolution/): Wilkes-Barre, PA – November 4, 2025 – Federal Hearings & Appeals Services (FHAS), a national leader in medical review and dispute resolution, today announced it has become the first organization to receive the URAC Independent Dispute Resolution (IDR) Designation. This achievement adds to FHAS's existing URAC accreditations in Independent Review Organization (IRO) and Health Utilization Management (HUM), underscoring the company’s leadership in meeting the highest industry standards for dispute resolution under the No Surprises Act.
- [The Federal IDR Operations Rule](https://www.fhas.com/resources/industry-updates/the-federal-idr-operations-rule/): Nearly five years after the No Surprises Act (NSA) took effect to protect patients from unexpected medical bills, efforts continue to streamline billing disputes between healthcare providers and insurers. Here, we explain what the Federal IDR Operations Rule means for payers and providers, where it stands, and how it aims to improve the Independent Dispute Resolution (IDR) process. 
- [UPDATE: CMS Portal Updates to Address Duplicate Dispute Challenges ](https://www.fhas.com/resources/industry-updates/update-cms-portal-updates-to-address-duplicate-dispute-challenges/): On July 1, 2025, the Centers for Medicare & Medicaid Services (CMS) introduced several enhancements to the IDR Portal affecting how disputes are initiated, how health plan types are classified, and new validation requirements. Since then, CMS has just announced further enhancements addressing duplicate submission errors caused by these updates. 
- [Important Updates to CMS IDR Portal Web Forms: What You Need to Know ](https://www.fhas.com/resources/industry-updates/important-updates-to-cms-idr-portal-web-forms-what-you-need-to-know/): The Centers for Medicare & Medicaid Services (CMS) has implemented several significant updates to the Federal IDR Portal's web forms on July 1, 2025. Since then, we have received a lot of questions about the changes, so we wanted to add some clarity about how the updates impact the dispute submission process.  
- [IDR Common Objections Series – Part 4](https://www.fhas.com/resources/industry-updates/idr-common-objections-series-part-4/): The IDR entity will need to confirm during the eligibility review whether a dispute satisfies the regulatory definition of a bundle and whether either party billed or paid for the items and services using a single service code. To do this, the entity will review supporting documentation submitted by both parties to verify that either:   
- [FHAS Receives Georgia Certification as Independent Review Organization](https://www.fhas.com/resources/industry-updates/federal-hearings-appeals-georgia-certification-iro/): Third state certification in 2025 expands FHAS’s IRO reach to over 29 states & territories nationwide
- [Your Money Matters: The FHAS Commitment to Fast Refunds](https://www.fhas.com/resources/industry-updates/fhas-timely-idre-refunds/): Under the No Surprises Act, an IDRE must refund the prevailing party its IDRE fee within thirty (30) calendar days. While the law is clear, problems persist across the system.
- [IDR Common Objections Series – Part 2](https://www.fhas.com/resources/industry-updates/idr-common-objections-series-part-2/): This is the second in a series of articles that will review the most common objections, errors, and issues seen in the Independent Dispute Resolution process.  Missed the first installment of the series? You can find it here:
- [IDR Common Objections Series – Part 1](https://www.fhas.com/resources/industry-updates/idr-common-objections-series-part-1/): This is the first in a series of articles that will review the most common objections, errors, and issues seen in the Independent Dispute Resolution process. 
- [Understanding CMS’s FAQ Part 69: New Rules for IDR Extensions and QPA Disclosures](https://www.fhas.com/resources/industry-updates/understanding-cmss-faq-part-69-new-rules-idr-extensions-qpa-disclosures/): While the document largely reiterates prior guidance on Qualified Payment Amount (QPA) calculations and disclosure obligations, the key development in this update is the introduction of a new extension pathway for providers, facilities, and air ambulance services who miss Independent Dispute Resolution (IDR) deadlines due to delayed or missing disclosures from health plans or issuers.
- [Utilization Review Services Offer a Solution to Competing Payment Pressures](https://www.fhas.com/resources/industry-updates/utilization-review-services-offer-a-solution-to-competing-payment-pressures/): One of the most pressing issues in the high-stakes healthcare arena is the financial tension between providers and health plans. Providers are focused on receiving fair compensation for their services, while health plans prioritize cost management in an effort to maintain competitive premiums.
- [CEO Advice for Payers and Providers Looking to Improve Their IDR Process](https://www.fhas.com/resources/industry-updates/ceo-advice-for-payers-and-providers-looking-to-improve-their-idr-process/): As the Independent Dispute Resolution (IDR) process under the No Surprises Act continues to evolve, healthcare executives must stay informed and proactive. Jim Bobeck, CEO of Federal Hearings and Appeals Services (FHAS), presents a thorough examination of the IDR landscape, emphasizing significant trends, effective practices, and opportunities for providers and payers to leverage the IDR process for more efficient revenue cycle management
- [CMS Clarifies Batching Rules: Eligibility Extends Through 90-Day Cooling-Off Period](https://www.fhas.com/resources/industry-updates/cms-clarifies-batching-rules-eligibility-extends-through-90-day-cooling-off-period/): As part of ongoing efforts by FHAS to provide much-needed clarity to payers and providers about the Independent Dispute Resolution (IDR) process, we recently reached out to the Centers for Medicare & Medicaid Services (CMS) for additional guidance on batching eligibility.
- [Controlling the Cost of Prior Authorizations is a Growing Concern](https://www.fhas.com/resources/industry-updates/controlling-the-cost-of-prior-authorizations/): More than 46 million prior authorization requests were submitted to Medicare Advantage (MA) insurers in 2022. Virtually all enrollees in Medicare Advantage (99%) are required to obtain prior authorization (PA) for some services – most commonly, higher cost services, such as inpatient hospital stays, skilled nursing facility stays, and chemotherapy. FHAS estimates 2024 PA requests will exceed 50 million.
- [Prevent Claims Submission Errors with an IDRE: A Quick Guide to How Links Are Triggered](https://www.fhas.com/resources/industry-updates/avoid-link-submission-errors/): If you’re still having trouble, don’t hesitate to reach out to the entity responsible for sending your link and invoice. At FHAS, we strive to provide clarity throughout the IDR process. We also utilize a quality check process to ensure links and invoices are sent on the same day. Fixing submission errors doesn’t have to be complicated. With some best practices and good communication with your IDRE, you can avoid claims submission errors.
- [Resubmission Offers One Chance to Correct Batching Errors](https://www.fhas.com/resources/industry-updates/idr-resubmission-tips/): When it comes to mistakes in batching, IDR participants will only have a single opportunity to resubmit the claim correctly, and limited time to do so. If the deadline is missed, the error is repeated, or a new one is made, the claim is likely to be closed permanently, without additional recourse. Be sure you know how to avoid this outcome by becoming more familiar with resubmission.
- [Benefits of the IDR Process for Insurance Carriers](https://www.fhas.com/resources/industry-updates/benefits-of-the-idr-process-for-insurance-carriers/): Based on this data, it’s not surprising that insurance carriers believe that participating in Independent Dispute Resolution does not benefit them. However, the reality is not nearly that simple. When completed correctly, IDR is a fair process that gives both payers and providers an equal opportunity to make their case. 
- [Understanding the Surprise Billing Act: What Insurers and Providers Need to Know](https://www.fhas.com/resources/industry-updates/understanding-the-idr-process-no-surprises-act/): Since its passage in 2022, insurers and providers are continuing to learn and implement the provisions of the Surprise Billing Act. While the act aims to protect patients from unexpected medical bills, it also introduces new requirements and challenges for healthcare professionals.
- [Compliance Matters: Knowing and Navigating the Latest IDR Timeline](https://www.fhas.com/resources/industry-updates/idr-compliance-filing-guidelines/): The overwhelming response to the 2022 passing of the No Surprises Act legislation has led to a growing backlog of federal Independent Dispute Resolution (IDR) claims. For eligible disputes, the Centers for Medicare & Medicaid Services (CMS) has established specific deadlines to govern the completion of each step. 
- [Where Providers and Health Plans Go Wrong In Filing IDR Disputes](https://www.fhas.com/resources/industry-updates/idr-common-mistakes/): The No Surprises Act was created to protect patients from unexpected medical bills and set up the Independent Dispute Resolution (IDR) process to sort out payment disagreements between healthcare providers, facilities, and insurance plans. 
- [Insurance Dispute Resolution: The Benefits of Arbitration](https://www.fhas.com/resources/industry-updates/insurance-dispute-resolution-the-benefits-of-arbitration/): The No Surprises Act (NSA) was enacted on December 27, 2020, to address certain instances of surprise billing – circumstances where individuals with private health plans and coverage receive unexpectedly high medical bills when they are unknowingly or unavoidably treated by an out-of-network (OON). For decades, patients struggled with surprise billing while payers and OON providers engaged in elongated reimbursement discussions. Through the enactment of NSA, Congress aimed to reduce the numbers of consumer complaints associated with surprise billing and its consequential adverse financial impacts for patients, providers, payers, and the overall healthcare system.
- [Steering Clear of Bias: Identifying IDRE Conflicts in IDR Conflict Resolution](https://www.fhas.com/resources/industry-updates/idr-conflict-resolution-avoiding-bias/): For healthcare providers and payers working with independent dispute resolution entities (IDREs) under the No Surprises Act, the rules around what constitutes a conflict of interest remain ambiguous in some areas. The blurred boundaries make this an uncertain landscape that parties feel they must tread carefully to steer clear of missteps.

## Pages
- [The Cooling Off Period: What Providers and Health Plans Need to Know](https://www.fhas.com/resources/idr-knowledge-base/the-cooling-off-period-what-providers-and-health-plans-need-to-know/): Updated for the 2026 Federal IDR Operations Final Rule (CMS-9897-F). 
- [Cooling-Off Calculator](https://www.fhas.com/cooling-off-calculator/): Under the No Surprises Act's independent dispute resolution (IDR) process, a 90-day cooling-off period can restrict when a new dispute may be initiated between the same parties. We created this tool to quickly determine whether a cooling-off period is still in effect for your case.
- [IDR Final Rule Timeline](https://www.fhas.com/resources/idr-knowledge-base/idr-final-rule-timeline/): FHAS has carefully assembled this timeline to help clarify the effective and compliance dates and general timing expectations for regulatory shifts in the final operations rule for the Independent Dispute Resolution program. See also our perspectives on the rule in our recent article and video where we break down the most impactful points within the rule.
- [IDR Resource: Batching Guidelines](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-batching-guidelines/): Amended 6/5/2026
- [FHAS Perspective on the Final IDR Operations Rule](https://www.fhas.com/final-idr-operations-rule/): SUBSCRIBE TO THE FHAS INSIDER
- [FHAS IDR Client Meetings](https://www.fhas.com/resources/idr-knowledge-base/idr-clarity-through-fhas-client-meetings/): At FHAS, we understand that navigating the IDR process can raise a lot of questions. That’s why we are dedicated to keeping our clients informed and supported throughout the entire process. One way we do this is through personalized client meetings with our Account Services team.
- [Events](https://www.fhas.com/events/): 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
- [Subscribe to the FHAS Insider](https://www.fhas.com/subscribe-to-the-fhas-insider/): Our monthly newsletter, the FHAS Insider, delivers timely updates, expert insight, and practical guidance across medical review, independent dispute resolution (IDR), and more — straight to your inbox every month.
- [Book a Call](https://www.fhas.com/book-a-call/): Let's talk about how FHAS can deliver solutions that meet your business or agency’s needs.  
- [Webinar – 2025 IDR Year in Review: What’s Changed & What’s Ahead](https://www.fhas.com/webinar-2025-idr-year-in-review/): Speakers: Jim Bobek, CEO; Luigi Romano, Director of IDR Services; Lauren Masulis, IDR Account Services Supervisor
- [Careers](https://www.fhas.com/about-fhas/careers/): At FHAS, we solve complex healthcare challenges. For 30 years, we've provided expert medical reviews, dispute resolution, and claims adjudication services to healthcare providers, payors, and government agencies. Our team of specialists has processed millions of cases with a commitment to quality and integrity.
- [Make a Payment](https://www.fhas.com/make-a-payment/): If you have any questions about submitting payment on your dispute, please contact our finance team at IDREpayments@fhas.com.
- [About FHAS](https://www.fhas.com/about-fhas/)
- [Resources](https://www.fhas.com/resources/)
- [Who We Serve](https://www.fhas.com/who-we-serve/)
- [IDR Resource: How To Make Your IDR Documentation Stronger](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-how-to-make-your-idr-documentation-stronger/): The most important factor impacting an Independent Dispute Resolution (IDR) entity’s determination is the accuracy and completeness of each party’s documentation.
- [IDR Resource: FHAS Determinations Without Payment From Carriers](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-fhas-determinations-without-payment-from-carriers/): The role of a certified IDR entity under the No Surprises Act is to choose from the two competing payment offers submitted by each party to the dispute. This decision must occur within 30 business days of finalization of the selection of the entity, which is when the entity testifies to no conflict of interest. When a determination is made the entity will notify the plan, provider, facility, or provider of air ambulance services, as well as the Departments.
- [IDR Resource: IDR Batching Vs. Bundling](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-idr-batching-vs-bundling/): As billing disputes involving a single item or service are common, there are circumstances when an IDRE can review multiple items or services simultaneously to better streamline the IDR process and reduce costs. Batching and bundling both allow FHAS to review disputes as a group, but only under certain conditions. The terms “batching” and “bundling” are often used interchangeably by parties, but it is important to know they are two distinctly different dispute types. When submitted incorrectly, a resubmission is required. To help ensure disputes are handled properly and efficiently, we have developed a guide outlining FHAS procedures and qualifications for bundled and batched disputes.
- [IDR Resource: IDR Entity Vs. CMS Responsibilities](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-idr-entity-vs-cms-responsibilities/): Under the No Surprises Act, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury have certified 13 organizations to serve as Independent Dispute Resolution (IDR) entities in the Federal IDR process.
- [IDR Resource: Closures in the IDR Process: Key Differences Explained](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-closures-in-the-independent-dispute-resolution-process-key-differences-explained/): A dispute can be considered not eligible to proceed in the IDR process for the following reasons;
- [Proposed Federal Rule Changes for 2025: What to Know](https://www.fhas.com/proposed-federal-rule-changes-for-2025-what-to-know/): The implementation of the No Surprises Act (NSA), which protects patients from unexpected bills from out-of-network providers, is an ongoing process. With new Federal rules projected to take effect in 2025, it’s important for providers and payers to prepare now for changes in the dispute resolution process.
- [IDR Resource: Determining Eligibility for Federal IDR](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-determining-eligibility-for-federal-idr/): Disputed payments must be for items or services furnished on or after January 1, 2022.
- [IDR Resource: Understanding the Federal (IDR) Process with FHAS](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-understanding-the-federal-idr-process-with-fhas/): Healthcare billing disputes can be complex and time-consuming, especially when they involve out-of-network (OON) services. Thanks to the No Surprises Act (NSA), which was enacted on December 27, 2020, the process for resolving such disputes has become more structured and fair, particularly with the establishment of the Independent Dispute Resolution (IDR) process.
- [IDR Resource: FHAS Payment Guide for IDR Fees](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-fhas-payment-guide-for-idr-fees/): The payment of the certified Independent Dispute Resolution (IDR) entity fee and IDR administrative fee is essential to moving a dispute forward in the federal IDR process.
- [IDR Resource: How to File a Dispute](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-how-to-file-an-independent-dispute-resolution/): Independent Dispute Resolution (IDR) is utilized as a means for resolving payment disputes between healthcare providers and health plans, in line with the CMS No Surprises Act.  The goal of the IDR process is to provide an impartial decision on fair payment without involving the patient in the process or subjecting them to surprise medical bills for out-of-network services. The IDR process involves the following steps:
- [IDR Resource: How To Choose An Impartial IDRE](https://www.fhas.com/resources/idr-knowledge-base/idr-resource-how-to-choose-an-impartial-idre/): While the URAC designation establishes our commitment to neutrality, transparency, and clinical review excellence, we want to empower businesses to make informed decisions.  This guide explores key indicators to assess the impartiality of an IDRE:
- [IDR Knowledge Base](https://www.fhas.com/resources/idr-knowledge-base/): Start here to gain the knowledge and confidence you need to navigate the dispute resolution process effectively.
- [Peer Review Panel](https://www.fhas.com/about-fhas/peer-review-panel/): FHAS recruits the nation's top medical professionals, attorneys, and experts nationwide, including physicians, dentists, healthcare legal experts, non-physician practitioners, and support providers like Occupational and Physical Therapists and mental health professionals. We perform URAC-compliant in-house credentialing with primary source verification of licensure and board certifications.
- [Leadership](https://www.fhas.com/about-fhas/leadership/): Under Janice’s leadership, FHAS manages over seven federal medical review contracts totaling more than one million independent medical reviews, while maintaining a 100% client retention rate since inception. She has driven measurable performance gains through efficiency initiatives and innovative productivity models that increased operating revenue by 30%. Known for blending executive precision with a collaborative, people-centered approach, she fosters both organizational growth and team development. 
- [Accreditations](https://www.fhas.com/about-fhas/accreditations/): Our Accreditations & Associations We have earned industry gold standard URAC accreditations in IRO and HUM, ISO 9001:2015 certification, and NAIRO membership, demonstrating our commitment to efficiency, transparency, and unbiased review excellence across our full suite of services.
- [Company](https://www.fhas.com/about-fhas/company/): FHAS, a URAC-accredited Independent Review Organization (IRO) and Health Utilization Management company, is a trusted national leader in medical claims review, dispute resolution, legal adjudication, and business process outsourcing. As the industry’s premier Independent Dispute Resolution Entity (IDRE) and a leading Medicare and claims review partner, FHAS leverages nearly 30 years of expertise to deliver fair, accurate, and timely solutions for healthcare providers, payors, and federal and state government programs.
- [Industry Updates](https://www.fhas.com/resources/industry-updates/)
- [State Government](https://www.fhas.com/who-we-serve/state-government/): State and territory agencies must manage tight budgets, ensure compliance with federal and state regulations, and deliver equitable access to care under public scrutiny. FHAS integrates with agency operations using URAC-accredited, clinician-led reviews that accelerate coverage decisions, enhance fairness in hearings, and ease the strain of assistance program administration.
- [Government Contractors](https://www.fhas.com/who-we-serve/government-contractors/): Federal and State contractors face constant pressure to balance speed, compliance, and cost in delivering program support. FHAS provides accredited, automation-enabled clinical review services that help contractors meet performance metrics, reduce risk exposure, and deliver outcomes federal agencies can trust.
- [Federal Government](https://www.fhas.com/who-we-serve/federal-government/): Federal program teams must tighten improper-payment risk, satisfy auditors, and make timely beneficiary decisions under heavy scrutiny. FHAS integrates with agency operations using URAC-accredited, clinician-led reviews that shorten decision timelines, strengthen defensibility, and reduce the burden of post-payment audits.
- [Home](https://www.fhas.com/): FHAS is a certified Independent Dispute Resolution Entity (IDRE) under the No Surprises Act.
- [Provider Outreach and Education](https://www.fhas.com/our-services/provider-outreach-education/): Our Provider Outreach and Education service follows the structured TPE process outlined by CMS, adapted to meet the needs of insurance payors:
- [Hearings and Adjudication Services](https://www.fhas.com/our-services/hearings-and-adjudication-services/): FHAS specializes in member eligibility reviews, appeals, and related adjudication services for state agencies, immediately expanding your capacity to process complex cases while your staff focuses on strategic priorities. Our administrative law judges integrate seamlessly with your operations, delivering legally sound determinations that reduce appeal rates and satisfy federal oversight requirements.
- [Appeals Management](https://www.fhas.com/our-services/appeals-management/): FHAS revolutionizes appeals management by combining advanced automation with clinical expertise to eliminate backlogs and accelerate resolution outcomes across all health programs. As a URAC-accredited IRO, our automated workflows integrate regulatory compliance, clinical intelligence, and data-driven decision-support tools to deliver timely, defensible determinations that reduce administrative costs while improving accuracy across the entire appeals lifecycle.
- [Independent Dispute Resolution (IDR)](https://www.fhas.com/our-services/independent-dispute-resolution/): The Departments of Health and Human Services, Labor, and the Treasury have certified Federal Hearings and Appeals Services as an independent dispute resolution (IDR) entity within the federal IDR process. In this role, FHAS facilitates disputes between out-of-network providers, facilities, or air ambulance service providers and group health plans, health insurance issuers in both the group and individual markets, as well as Federal Employees Health Benefits (FEHB) carriers.
- [Health Plans](https://www.fhas.com/who-we-serve/health-plans/): Health Plans face increasing pressure to control costs, mitigate risk, and deliver timely, impartial decisions. FHAS combines accredited, independent clinical expertise with technology-enabled workflows and automation to streamline operations, improve accuracy, and ensure defensible, compliant outcomes.
- [Medical Review](https://www.fhas.com/our-services/medical-review/): As a URAC-accredited IRO with Health Utilization Management (HUM) accreditation, FHAS provides tailored prospective, concurrent, and retrospective medical review services—seamlessly integrating into any stage of your internal or external claims process. 
- [Summary Report: CMS Q3-Q4 2024 Data Recap](https://www.fhas.com/summary-report-cms-q3-q4-2024-data-recap/): CMS Q3–Q4 2024 Data Recap The Federal Independent Dispute Resolution process isn't just growing—it's exploding. With an unprecedented 40% surge in H2 2024 and more than 853,000 disputes filed, healthcare providers and payers are experiencing growing pains according to the CMS Semi-Annual 2024 Q3 & Q4 Data Report. Key findings include: 
- [May Webinar -The Evolving IDR Landscape](https://www.fhas.com/idr-landscape-2024-q1-q2-recap/): CMS recently released their Q1-Q2 2024 data report and summary. But what does it practically mean for payors and providers?  
- [White Paper: CMS Q1-Q2 2024 Data Recap + Analysis](https://www.fhas.com/white-paper-idr-volume-spikes-amid-growing-market-maturity/): CMS Q1–Q2 2024 Data Recap + Exclusive FHAS AnalysisThe Federal Independent Dispute Resolution (IDR) process is evolving rapidly—and the numbers prove it. In the first half of 2024 alone, over 610,498 disputes were initiated through the federal portal, marking a 56% surge from late 2023.
- [April Webinar Registration](https://www.fhas.com/webinar-payor-provider-trust-prior-authorization/): This fireside chat brings together industry experts to explore how trust and collaboration can transform the prior authorization process. We’ll delve into the main reasons claims are denied, the role of education and information sharing in reducing these issues, and how recent regulatory changes are shaping the future of prior authorization.
- [Our Services](https://www.fhas.com/our-services/): As the leading Independent Dispute Resolution Entity (IDRE) in the nation, FHAS provides a fair, efficient, and cost-effective resolution process for payment disputes between healthcare providers and health plans.

## Global Sections
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## Categories
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