Skip to main content

Federal Independent Dispute Resolution

Maximus is a certified IDR entity under the Federal No Surprises Act, delivering fast, accurate, and impartial dispute resolution between out-of-network providers and health plans.

We arbitrate your disputes to ensure fast, accurate decisions

Trained IRO experts

Our clinicians and reviewers ensure impartial, evidence-based resolutions backed by decades of independent review experience.

Efficient process

Our dispute management system drives prompt decisions, keeping you informed at every stage.

Robust quality assurance

Multi-layer QA processes facilitate accurate, defensible determinations.

URAC, NAIRO, National Association of Indepent Review Organization, ISO logo

Accreditations and Certifications

Maximus has earned FedRAMP authorization, recognition as a Quality Improvement Organization (QIO)-like entity, certifications in ISO 9001, ISO 20000, and ISO 27001, and other accreditations.

  • Maximus has been granted full accreditation by URAC as an Independent Review Organization - External Review. URAC develops national standards to improve quality, protect consumers, and improve health outcomes. 
  • Maximus is a NAIRO member. NAIRO is the leader in independent medical review
  • Maximus is ISO 9001:2015, ISO/IEC 20000-1 Certified, ISO/IEC 27001 Certified

Account Services

Our Account Services team provides a neutral forum to all parties participating in the Federal IDR Process. Through clear communication, timely responses, and scheduled touchpoints, we ensure transparency and keep participants informed throughout the process.

Dispute review and process clarity

  • Provide updates on dispute status
  • Confirm receipt of requested documentation
  • Maintain consistent communication touchpoints through the dispute process

Reporting support

  • Offer tailored dashboards highlighting party metrics
  • Provide Determination and Refund Reports upon request
  • Respond to reporting inquiries and explain requested data elements

FED NSA guidance

  • Share CMS provided clarifications to guidance
  • Offer CMS resources to promote understanding and confidence in the process

Schedule a session

Parties may request meeting sessions to review dispute activity, discuss reporting needs, or address general process questions. Sessions are structured to ensure neutrality and provide clarity.

To learn more or schedule a meeting, please reach out to our Account Manager at courtneyrwilson@maximus.com.

Contact information

We want to hear from you

Include with your Inquiry:

  • Dispute Number (include in subject line)
  • Contact information (First Name, Last Name, Email Address, Telephone Number)
  • Who you Represent
  • Summary of inquiry
  • Preferred Method of Communication

Questions about the Federal IDR process

Any inquiries related specifically to the Federal IDR process, or to initiate a dispute, should be directed to the official CMS IDR email: FederalIDRQuestions@cms.hhs.gov.

Questions about the No Surprises Act

For any questions regarding the No Surprises Act, or for more information regarding any of its provisions, please visit: https://www.cms.gov/nosurprises

The information provided on this website is for informational purposes only. Maximus is an independent and neutral certified Independent Dispute Resolution (IDR) entity. Nothing on this site constitutes legal advice, professional guidance, or a recommendation regarding any specific dispute, action, or legal matter. Maximus assumes no responsibility for actions taken based on this content. The materials provided are not intended to replace or supersede any applicable statutes, regulations, arbitration rules, or formal guidance issued by governing authorities or regulatory bodies.