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IDR: The Best Solution to Protect Patients from Surprise Medical Bills

Physicians and providers agree that independent dispute resolution (IDR) is the best federal solution to prevent surprise medical bills while protecting patient access to emergency care.

IDR is a simple and efficient solution that incentivizes providers to charge reasonable rates, and insurers to pay appropriate amounts. In New York, IDR has successfully saved consumers $400 million and reduced out-of-network billing 34 percent, according to the New York State Department of Financial Services. Unlike government rate setting, IDR takes into account the increased costs associated with rural health care and ensures rural Americans’ access to health services continue to be protected. In fact, according to a recent poll, the majority of Americans prefer IDR to rate setting. 

A successful approach should include a workable IDR mechanism without a minimum qualifying threshold. Recent legislative proposals would only allow providers to access IDR when the median in-network amount for that service is over a certain dollar threshold ($750 in the latest HELP/Energy & Commerce proposal). Such a high threshold would lock emergency physicians out from IDR over 99 percent of the time. 

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