Short answer. If the 30-business-day open negotiation period ends without agreement, either party can start federal IDR by sending a Notice of IDR Initiation to the other party and submitting it through the Federal IDR portal during the 4-business-day window that begins on the 31st business day. The initiation date is the day the Departments receive the notice.
When you can file
- Initial payment or denial arrives. You have 30 business days to send an open negotiation notice.
- Open negotiation runs 30 business days from the day that notice is sent.
- No agreement? The initiation window is 4 business days, beginning on the 31st business day after open negotiation started.
- Miss the window and the claim is no longer eligible for federal IDR.
One exception: after a determination, the party that initiated cannot bring the same payer and same service back to IDR for a 90-calendar-day cooling-off period. Claims whose window fell inside that period get a 30-business-day initiation window once it ends. Use the deadline calculator to count business days around federal holidays.
What the notice includes
- Names and contact information for both parties
- The item or service, date(s) of service, service code and where it was furnished
- Claim number, the initial payment amount, and the QPA
- Whether the dispute is batched — otherwise one notice per item or service
- Your preferred certified IDR entity
- An attestation that the items are eligible for the federal process, plus proof open negotiation was completed
What happens after you file
- Day 0: the Departments receive the notice — this is the initiation date.
- Within 3 business days: the other party may object to your preferred entity. If it doesn't, your pick is treated as jointly selected unless that entity has a conflict.
- By business day 4: the parties report the selected entity, or the failure to select, through the portal. If they can't agree, the Departments assign one.
- Eligibility review: the 2026 final rule sets 5-business-day eligibility review deadlines.
- Within 10 business days of selection: both sides submit final offers and pay fees.
- Within 30 business days of selection: the entity issues its determination.
- Within 30 calendar days of the determination: any amount owed must be paid.
Fees at initiation (2026)
The administrative fee is $15 per party per dispute after the May 2026 final rule (CMS-9897-F), down from $115. Certified entity fees run roughly $200–$840 for a single dispute and $268–$1,173 for a batch. Details on IDR fees.
Five ways initiation notices fail
- Counting the window in calendar days instead of business days
- Filing federally when the claim belongs in a state process — common in bifurcated states like Texas and New York
- No documentation that open negotiation actually happened
- A batch that mixes payers, unrelated codes, or exceeds 50 line items
- Naming a preferred entity with a conflict of interest
FAQ
How long do you have to initiate federal IDR?
Four business days, beginning on the 31st business day after the open negotiation period started. If the dispute falls within a 90-day cooling-off period, a 30-business-day window opens after it ends.
What is the IDR initiation date?
The date the Departments receive the Notice of IDR Initiation through the Federal IDR portal.
What if the other party does not respond to my choice of IDR entity?
If the non-initiating party does not object within 3 business days, the preferred certified IDR entity named in the notice is treated as jointly selected, provided it has no conflict of interest.
Can a health plan initiate IDR?
Yes. Either party to the open negotiation may initiate, although providers initiate the overwhelming majority of disputes.
Sources: Departments of Labor, HHS and Treasury, Notice of IDR Initiation form and instructions; Federal IDR information collection documents; CMS-9897-F (2026 IDR operations final rule). IDR Filings is not a law firm and this page is not legal advice.