Resource
IDR Glossary for Provider Teams
Plain-language definitions for common Federal IDR and surprise-billing terms.
Qualified IDR item or service
An item or service within federal surprise-billing protections for which Federal IDR may determine the out-of-network rate, provided no controlling state law or All-Payer Model applies.
QPA
The qualifying payment amount, generally based on a plan or issuer's median contracted rate under federal methodology.
Certified IDR entity
An independent organization certified by the Departments to make eligibility and payment determinations in the Federal IDR process.
Open negotiation
The required negotiation period that precedes a Federal IDR initiation.