Frequently Asked Questions
Q1. Do I have to use the Federal IDR portal to submit a request/dispute?
A. The Federal Independent Dispute Resolution (IDR) portal provides you with free, secure, real-time, internet-based access to electronically submit your request and receive an immediate confirmation that the transmission was successful. In addition to the Federal IDR portal, you can submit your request via fax or U.S. mail. The IDR portal and fax options provide the ability to avoid the cost of postage and inherent delays incurred by mailing. You may visit https://www.cms.gov/nosurprises/consumers/medical-bill-disagreements-if-you-are-uninsured to start a payment dispute through the Federal IDR portal or to obtain additional information about submitting your dispute through fax or mail. Please do not submit duplicate dispute requests, as that will delay the processing of your dispute request.
Q2. What information do I need to submit for a dispute?
A. The Federal IDR portal will assist you in submitting all required information. You may visit https://www.cms.gov/nosurprises/consumers/medical-bill-disagreements-if-you-are-uninsured to start a dispute through the Federal IDR portal. If you prefer to submit your dispute through fax or mail, please use the Patient-Provider Dispute Resolution Form to submit your request. You must include the following information:
- The name of the services and/or items you want to dispute
- The date you received the services and/or items
- A short description of the services and/or items
- A copy of the bill for the services and/or items you want to dispute (the copy can be a photocopy or an electronic image as long as the document is readable)
- A copy of the Good Faith Estimate (GFE) for the services and/or items you want to dispute (the copy can be a photocopy or an electronic image as long as the document is readable)
- The contact information for the health care provider or facility, including name, email address, phone number and mailing address
Q3. What if I don’t have a Good Faith Estimate (GFE)?
A. If a GFE was given to you, but you do not have a copy of it, you should contact your provider and ask for a copy. If you were never provided a GFE, you are not eligible for the dispute resolution process. In that case, you may contact your health care provider to attempt to negotiate your bill and ask for financial assistance.
Q4. Does the portal offer the opportunity to check the status of my request?
A. No. The Federal IDR portal only receives your dispute request and any additional documentation.
Q5. My total bill is at least $400 more than what I expected to be charged based on the GFE. Does that make me eligible for the Patient-Provider Dispute Resolution (PPDR) process?
A. The difference between the GFE and the total bill is not what makes you eligible to participate in the PPDR process. The GFE may contain estimated costs from more than one provider or facility. You are eligible for the PPDR process if the bill from a provider or facility is at least $400 more than the estimated cost shown on the GFE for that same provider or facility.
Q6. I received a bill from a provider or facility that was not on the GFE. Am I eligible for the PPDR process?
A. If you received a GFE prior to receiving health care services or items, and you received a bill related to those same services or items from a provider or facility that was not listed on the GFE, you may be eligible for the PPDR process. You may visit https://www.cms.gov/nosurprises/consumers for additional information or contact the No Surprises Help Desk at 800-985-3059.
Q7. Where can I find more information about the PPDR process?
A. Please visit https://www.cms.gov/nosurprises/consumers for additional information or contact the No Surprises Help Desk at 800-985-3059.