C2C Innovative Solutions, Inc. Independent Dispute Resolution (IDR)

C2C is designated as a certified Independent Dispute Resolution Entity (IDRE) by the U.S. Department of Health and Human Services, the Department of Labor and the Department of the Treasury.

Drawing on our federally recognized expertise, we can help providers or facilities resolve disputes with health plans about payment amounts for out-of-network services covered by the federal No Surprises Act.

By choosing C2C, you will gain access to a trusted, quality-focused organization with experienced attorneys, physicians and other specialized professionals who will review your case and make a payment determination that is independent, fact-based and fair. If you are a plan or provider and would like to submit a dispute, please visit the CMS portal.

C2C’s IDRE Inquiry Submission Portal

For inquiries related to your IDR dispute, use the C2C secure inquiry portal at IDR Inquiry Submission Portal.

C2C's IDRE Dispute Status Lookup Tool

Quickly check the status of a dispute with the Dispute Status Lookup tool.

URAC Accredited Independent Review Organization

Following a rigorous screening process, C2C achieved URAC accreditation in 2017.

With C2C, the review process and decisions:

Are evidence-based, timely, clear and free of conflict,
Conducted by actively practicing, board-certified physicians, nurses, coders, attorneys and other allied health professionals and
Compliant with Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Act.

Our Experience

A URAC-accredited and ISO-certified organization, C2C has more than 20 years of experience in the health care industry as a nationally recognized Qualified Independent Contractor (QIC) and Independent Review Organization (IRO).

Working from an extensive knowledge and understanding of the review process, C2C has provided timely and high-quality reviews for more than 7 million claims, including but not limited to claims involving:

Inpatient hospital services (diagnosis related groups and length of stay)
Skilled nursing services
Home health
Ground and air ambulance transportation
Physician services
Laboratory and imaging services
Durable medical equipment
Behavioral health
Pharmacy/formulary review

As an independent review organization, C2C’s expertise further includes:

Clinical and non-clinical reviews
Experimental/investigational reviews
Contractual disputes
Out-of-network services

C2C’s nationally recognized expertise includes administrative management, medical decision-making, health care support services, claims management and independent payment dispute resolution between providers and plans.

Our Team

C2C’s nationwide panel includes more than 1,200 board-certified physicians, nurses, coders, attorneys and other allied health professionals experienced in the review and application of the statutes, laws, regulations, policies, guidelines and coverage criteria that are relevant to the facts of your case. C2C’s fully licensed attorneys are certified by the American Health Law Association and provide unbiased expertise. With C2C, you can be assured your case will be addressed by a topic-area expert.

CMS

Federal IDR Process

Any inquiries related specifically to the Federal IDR process should be directed to the official CMS IDR email.

No Surprises Act

For questions regarding the No Surprises Act or information regarding any of its provisions, please visit the CMS No Surprises website.

To learn more about C2C’s other health care solutions, please visit: https://www.c2cinc.com.