How do emergency groups batch IDR claims?

By payer, by visit code, by window: claims combine into one dispute when they share the same payer and group and the same or similar service code, with service dates inside a 30 business day period. A month of 99284 claims for one payer typically forms one or two batches.

What are the deadlines for an emergency IDR claim?

The payer must respond to a clean claim within 30 days. Open negotiation starts within 30 business days of the response and lasts 30 business days, and arbitration must be initiated within 4 business days after that. A 90 calendar day cooling-off follows each decision for the same service and payer.

What do high-volume emergency filers win?

The largest 2025 filers won 89 to 93 percent of decided disputes: Precision Emergency Physicians at 88.6 percent across 25,555 disputes, Southeastern Emergency Physicians at 92.5 percent, and Fremont Emergency Services at 93.2 percent.

Answers / Filing at volume

Filing federal IDR at emergency volume

Large emergency groups file tens of thousands of No Surprises Act IDR disputes a year, batching claims by payer and visit code within the 30 business day service window. Every claim runs the same sequence: payer response within 30 days, open negotiation for 30 business days, then 4 business days to initiate arbitration. The published record shows high-volume filers winning around 90 percent of decided disputes, with costs of $15 per party per dispute plus a refundable entity fee.

Groups already file at this scale

The 2025 files put names and numbers on volume filing. Precision Emergency Physicians appears in 25,555 disputes with an 88.6 percent decided win rate. Southeastern Emergency Physicians appears in 24,049 and won 92.5 percent. Fremont Emergency Services, the Nevada group whose litigation against United Healthcare made national news, filed 19,963 and won 93.2 percent. These are operations that treat arbitration as a production system with intake, evidence, offers, and deadlines managed per payer, and their win rates sit above the specialty's already high average.

Batching is the unit of work

A month of short-paid level 4 visits for one payer does not become hundreds of disputes; it becomes a handful of batches. Claims combine into a single dispute when they share the payer, the group, and the same or similar service code, with all dates of service inside a 30 business day period. For an ED group the natural batch is payer by E/M level by window, which turns a quarter of claim flow into a predictable count of disputes and spreads the fixed fees across every line inside each one.

Deadlines at volume

Each claim carries its own sequence. The payer owes an initial payment or denial within 30 days of a clean claim. Open negotiation must start within 30 business days of that response and runs for 30 business days. If it fails, the dispute must be initiated in the next 4 business days, a window that forgives nothing. After a decision, the same service with the same payer observes a 90 calendar day cooling-off before new filings, with the accumulated claims filed in the 30 business days that follow. One missed window on one batch can strand hundreds of claims, which is why volume filers run the calendar as infrastructure rather than as a task list.

What it costs to run

Government costs stay small at any scale: $15 per party per dispute and a certified IDR entity fee of a few hundred dollars that returns on a win. The structural decision is representation. At the specialty's nearly $5 billion in 2025 decided awards, a contingency arrangement prices the vendor as a percentage of the group's revenue recovery, every year, forever. Lido IDR runs the batching, the calendar, and the offers for a flat fee per arbitration, with every offer priced from the published record at idrexplorer.com.

Run arbitration as infrastructure

Lido IDR manages batching, deadlines, and offers across the full claim flow for a flat fee per arbitration. Talk to an IDR specialist.