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HMT Billing Solutions

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Federal IDR Support From Qualification to Determination

HMT manages the federal Independent Dispute Resolution process for eligible out-of-network claims, from qualification and open negotiation through offer preparation, submission and determination.

Out-of-network payment disputes can create significant revenue challenges for healthcare organizations. Under the No Surprises Act, eligible disputes may proceed through the federal Independent Dispute Resolution (IDR) process when payer negotiations do not resolve the payment issue.

For eligible out-of-network claims, an underpayment may be addressed through the dispute-resolution process rather than simply being written off. The No Surprises Act provides a defined path that can include an open negotiation period with the payer followed by federal IDR when the dispute remains unresolved.

The process is procedurally demanding. Deadlines begin running when payment or denial notices arrive. Eligibility rules determine which claims qualify, batching rules affect how related claims can be submitted, and administrative fees can make some disputes uneconomical to pursue. Missing a critical deadline can eliminate an otherwise viable dispute.

That is where HMT comes in. We manage the process from claim qualification and open negotiation through offer preparation, supporting documentation, submission and determination tracking.

Out-of-Network & Disputes

Our IDR Experience

42,000+
Federal IDR Claims Submitted
98%
Determinations in Which Our Offer Was Selected

Source: Federal IDR portal records. Figures as of August 2026.

Results are not guaranteed and depend on claim eligibility, supporting documentation and applicable IDR requirements.

How it works

Our IDR Process

  1. Qualification

    Determine whether the claim meets applicable federal IDR requirements.

  2. Open Negotiation

    Manage the required negotiation period with the payer.

  3. Offer Preparation

    Prepare the offer and the supporting documentation that goes with it.

  4. IDR Submission

    Submit eligible disputes through the federal IDR process.

  5. Determination Tracking

    Monitor the dispute through to final determination.

IDR Works Best When It Is Connected to Your Revenue Cycle

IDR decisions should not happen in isolation from your billing operation. Reviewing payment patterns, payer behavior and claim history helps identify which disputes are worth pursuing and where reimbursement issues may be recurring.

Already have a billing company? No problem. HMT can manage IDR separately against claims billed by another vendor.

Out-of-Network & Disputes

IDR & Out-of-Network Services

Sold individually or bundled. Most engagements combine two or three.

  • Federal IDR Services

    End-to-end management of eligible federal IDR disputes: qualification, open negotiation, offer preparation, submission and determination tracking.

    Explore Federal IDR Services

  • No Surprises Act Support

    Support with eligible surprise-billing requirements, including notice and consent considerations, claim handling and dispute workflows.

    Explore No Surprises Act Support

FAQ

Questions We Get Asked

Can you handle IDR if another company handles our billing?

Yes. HMT can manage eligible IDR claims independently, even when routine billing is performed by another billing company or an internal team. Nothing has to move for the dispute work to start.

Do you determine which claims are worth pursuing?

Yes. We evaluate eligibility, applicable requirements and dispute economics before recommending that a claim proceed. Administrative fees apply per dispute, so some low-value claims are not economical on their own, and where the rules permit related claims to be batched the economics can change substantially.

Do you handle the entire IDR process?

Yes. Depending on the engagement, HMT can manage qualification, open negotiation, offer preparation, submission and determination tracking. You decide how much of it we run.

Related

Other Services We Offer

Or take it as one engagement: End-to-End Revenue Cycle Management, ER Billing Services, Urgent Care & Clinic Billing and Hospital & Facility Billing.

Have Eligible Out-of-Network Claims?

Let HMT review your situation and determine whether your claims may be appropriate for the federal IDR process.

Review My OON ClaimsTalk to an IDR Specialist

Need broader revenue cycle support? Get a Free Revenue Cycle Audit