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- HHS Creates Process for Resubmitting Improperly Batched or Bundled Claim Disputes
The Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) have created a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled. This new resubmission process, released on May 1, is automated in the federal IDR portal used by physicians and other providers to dispute out-of-network claims for patient services.
The CAP had supported the creation of the IDR process as part of the passage of the No Surprises Act. However, the CAP has taken issue with how the administration has implemented the law over the years and opposed measures that favored the insurance industry over physicians. For example, the CAP has argued for additional flexibility around batching claims for pathology services and for decreased fees for low-dollar disputes to ensure an equitable and accessible IDR system.
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.
For additional information and instructions on how to complete and submit the new Notice of IDR Initiation – Resubmission web form, refer to the following resource link below:
- User Guide: Notice of IDR Initiation – Resubmission Web Form
Questions can be directed to the Federal IDR Questions mailbox at FederalIDRQuestions@cms.hhs.gov.