Update as of May 8th, 2024:
The Federal IDR Team has identified a technical issue impacting an initiating party’s ability to submit accurate values in the Notice of IDR Initiation – Resubmission web form.
Initiating parties may receive a validation error if they try to enter less than a whole dollar amount in the following fields on the Notice of IDR Initiation – Resubmission web form:
- Qualifying Payment Amount (QPA)
- Cost sharing amount allowed
- Initial payment amount for the item(s) and/or service(s), (if applicable)
To circumvent this error,
- Submit the Notice of IDR Initiation – Resubmission web form dollar amount values listed above with the nearest whole dollar amount.
- After submitting, email your entity with the new dispute reference number and the correct value(s).
The Federal IDR Team continues to review the identified error for resolution and will provide updates as they become available.
On May 1st, 2024, FHAS received an important notification from CMS regarding a new resubmission process for Independent Dispute Resolution (IDR) cases. Please find below an overview of the changes and what they mean for you.
1. Improved Routing
Resubmissions will no longer be misrouted. The CMS fix ensures that all resubmissions are directed back to the originally assigned IDR entity, resolving previous issues where resubmissions went to the incorrect entity.
While the guidance always directed resubmissions back to the originally assigned IDRE, the previous entity selection response form did not adhere to the guidance.
2. An End to Resubmission Cycles
IDR entities are now required to specify the reason(s) why a batched dispute is considered incorrect. This will provide parties with a clearer understanding of why the original batched submission was deemed incorrect, streamlining the resubmission process.
3. Clarified Reasons for Resubmission
Resubmission links for incorrectly batched or bundled cases will be sent from a CMS web address, similar to how you receive your “Notice of Offer” link. These links are triggered by the IDR entity, ensuring transparency and accountability in the process. Should you encounter any issues, please contact IDRE@fhas.com if the original dispute was assigned to FHAS.
FHAS anticipates these enhancements will notably refine the dispute batching and bundling process, enhancing efficiency and user-friendliness for all parties involved. Our support team is readily available to address any questions or concerns you may encounter during this transition.
The full update from CMS is below:
The Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) are announcing the official release of a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled. This new resubmission process is automated in the Federal IDR portal; it will streamline Federal IDR operations and enhance the user experience.
OVERVIEW OF THE NEW PROCESS
Parties now have a new way to resubmit disputes that were originally improperly batched or bundled. Resubmission requests will come directly from the Federal IDR portal instead of from your certified IDR entity, and initiating parties now will have a unique web form they can access via a link in their resubmission email notification to complete the resubmission process.
If you are a party to a dispute that is eligible to be resubmitted to the Federal IDR process, you will receive an email notification from auto-reply-federalidrquestions@cms.hhs.gov. If you initiated the dispute, the resubmission email notification will contain a unique link to a new form called the Notice of IDR Initiation – Resubmission web form and instructions on the next steps. If you did not initiate the original dispute, your email notification will be informational and will not have a link.
Initiating parties have 4 business days from the date of the resubmission email notification to resubmit a dispute. The resubmission link will no longer work after the 4 business day window has passed.
RESUBMISSION REQUESTS RECEIVED ON OR BEFORE APRIL 30, 2024
If a certified IDR entity notified you on or before April 30, 2024, that a dispute you submitted was eligible for resubmission due to improper batching or bundling, please resubmit the dispute as instructed in the email from your certified IDR entity through the Notice of IDR Initiation web form. For information on how to resubmit these disputes, refer to the Notice of Initiation Web Form Job Aid.
The Notice of IDR Initiation web form will accept resubmitted disputes through May 6, 2024. After May 6, 2024, the Notice of IDR Initiation web form will no longer accept resubmitted disputes, and all resubmissions must be submitted via the Notice of IDR Initiation – Resubmission web form as described in the paragraph below.
RESUBMISSION REQUESTS RECEIVED ON OR AFTER MAY 1, 2024
Starting on May 1, 2024, certified IDR entities will notify parties through an email from the Federal IDR portal that a dispute is eligible for resubmission due to improper batching or bundling. Initiating parties will receive a resubmission email notification that will direct them to a unique web form called the Notice of IDR Initiation – Resubmission web form to complete the resubmission process.
EDUCATIONAL MATERIALS
For additional information and instructions on how to complete and submit the new Notice of IDR Initiation – Resubmission web form, refer to the following resources linked below:
- User Guide: Notice of IDR Initiation – Resubmission Web Form
- Recorded Demo: Notice of IDR Initiation – Resubmission Web Form
If you have questions feel free to comment below, email IDRE@fhas.com or call FHAS at (570) 779-5122 and ask for our IDR department.
Legal Disclaimer
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.
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