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Independent Dispute Resolution

Maximus is a certified IDR entity under the Federal No Surprises Act

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Find common questions and answers about the program including links to resources and payment methods. 

General Federal IDR Questions

Covered out of network (OON) Emergency services, Covered OON Air Ambulance services, Covered services provided by an OON provider during an in-network facility visit. Read more about the eligibility guidelines.

You can start a dispute on the IDR Initiation Form. Maximus’s IDR entity ID should be selected if you want Maximus as your IDRE.

Within 4 business days after the close of the open negotiation period (unless the “cooling off period” is applicable). Read more about the cooling-off guidelines.

Batching allows grouping multiple related items under one dispute if they share identical service codes or fall within the same Category I CPT code range. See the full batching and bundling guidelines for detailed criteria. 

Multiple items billed under a single service code or a single payment/denial covering multiple items. Read more about bundled disputes on the eligibility guidelines page.

 

Batching allows an initiating party to submit multiple related items or services for a single IDR dispute represented as a single patient encounter, identical service codes, or a Category I CPT code section.

Bundled disputes contain multiple items and services, but are represented by a single service code or single payment by one of the parties involved.

The cooling off period is a 90-calendar-day window after a payment determination during which the initiating party cannot submit another dispute for the same or similar items with the same non-initiating party. 

Read more about the cooling off period on the eligibility guidelines page.

Read more about general suggestions for documentation on documentation page.

For an objection to be considered, the information should be included in the IDRE Selection Response Form. You should provide documentation to support the eligibility objections. Objections should not be made after the selection of the IDRE.

 

If you haven’t received a Notice of Offer, please contact us at FedNSAArbitrations@maximus.com. Please ensure to include the dispute number and contact info.

 

For requests to extend the dispute process, contact CMS directly at FederalIDRQuestions@cms.hhs.gov.

 

To request the withdrawal of a dispute, please contact us at FedNSAArbitrations@maximus.com.

 

To schedule recurring meetings, please contact our Account Manager at courtneyrwilson@maximus.com

Payment Questions

Fastest way to pay:

Mail a check:

  • Maximus Federal, Attn: Fed NSA, PO Box 791753, Baltimore, MD 21279-1188

Send check overnight:

  • Maximus, Inc., Attention 791753, 1000 Stewart Avenue, Glen Burnie, MD 21061

For questions regarding the payment portal, please contact: FedNSAPaymentPortal@maximus.com.

Please contact us at FedNSAArbitrations@maximus.com. Please ensure to include the dispute number and contact info.

 

Making payments

Maximus has a specially designed payment portal for providers and insurance company representatives to make fee payments

Payment portal

Providers and representatives can make fee payments online with a credit / debit card or by eCheck and receive refunds. To get started, click the “Sign Up” link on the home page to create a new account. This is the fastest way to make a payment.

Payment portal

Mail a check

Maximus Federal
Attn: Fed NSA
PO Box 791753
Baltimore, MD 21279-1188

Send check overnight

Maximus, Inc.
Attention 791753
1000 Stewart Avenue
Glen Burnie, MD 21061

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CMS resources