Feds resume dispute-resolution process under the No Surprises Act for batched claims

The federal government officially resumed accepting new batched claims under the No Surprises Act on Dec. 15 following a long hiatus.

The Centers for Medicare & Medicaid Services first shut down the landmark law’s independent dispute resolution process on Aug. 3. This came after a Texas judge struck down the 600% increase to the fee physicians must pay to initiate mediation between payers and providers over out-of-network bills. 

IDR remained largely inactive until a partial relaunch in October. But industry advocates alerted the specialty on Friday about the resumption of new batch-claim submissions, allowing radiologists and others to submit multiple similar IDR requests at once to limit the administrative burden.

“The American College of Radiology strongly opposed the extended pause of the IDR process for batched claims, as many imaging claims eligible for dispute are less than the current $50 administrative fee required to be paid to initiate the process,” ACR reported Dec. 15. “While the college is pleased that the federal IDR portal is now completely reopened, there are significant concerns with the 20 business-day extension allowed for claims where the initiation deadline fell on any date between Aug. 3, 2023, and Dec.15, 2023.”

ACR noted that, when the portal first reopened in October, physicians were granted a 20 business-day extension to submit disputes for claims that had been on hold for two months. With the Dec. 15 resumption, CMS is offering the same 20-day window, despite batched claims being paused for twice as long. ACR said it is working with fellow societies representing emergency physicians and anesthesiologists to “communicate with CMS that additional time is needed.”

The resumption comes after a recent U.S. Government Accountability Office investigation found that the NSA’s rollout has been challenging for radiologists and other providers.