IDRE Services

Trusted, Independent Resolution Under the No Surprises Act

EdiPhy Advisors is a certified Independent Dispute Resolution Entity under the No Surprises Act, providing fair, objective, and compliant dispute resolution services. We support stakeholders through a rigorous, transparent process designed to operationalize and fulfill the legal protections of the No Surprises Act.

Certified Independent Dispute Resolution Entity

EdiPhy Advisors has been selected by the federal government to serve as an Independent Dispute Resolution Entity for disputes arising under the No Surprises Act. Our role is to provide independent, unbiased determinations in accordance with statutory and regulatory requirements. We approach every dispute with objectivity, consistency, and a commitment to procedural integrity.

 

Excellence Through Attorney-Led Arbitration

EdiPhy Advisors is unique in its commitment to excellence through using only trained attorneys as arbitrators.  There is rigorous and robust training and quality review to ensure consistency of approach and thoughtful consideration of the information submitted by the parties. Continuous quality improvement while maintaining timely and accurate response is a hallmark of the EdiPhy process.  The goal is timely, impartial review and the right decision for the right reason in every case.

Support for Initiating and Non-Initiating Parties

EdiPhy Advisors works with both initiating and non-initiating parties involved in the IDRE process. EdiPhy Advisors has dedicated resources that maintain relationships and are responsive to initiating and non-initiating parties. We are committed to clarity, transparency, and consistency throughout the process. 

 

 

 

A Clear, Structured Review Process

Our IDRE process follows established federal requirements and timelines. Submissions are reviewed by qualified professionals with appropriate expertise, and determinations are supported by clear rationale aligned with regulatory criteria. This structured approach supports confidence in the process and trust in the outcome.

  1. Dispute Initiation, Assignment and Conflict of Interest Analysis

    The initiating party initiates a dispute on the CMS portal and the non-initiating party responds to the initiation.  The IDRE selection is made by CMS either through agreement of the parties, or by random assignment. When EdiPhy receives notice of its selection, EdiPhy conducts a rigorous Conflict of Interest check based on submission information to ensure that there is no Conflict of Interest before accepting the dispute for resolution.  Conflict of Interest analysis is also undertaken to ensure that arbitrators are free from Conflicts of Interest before undertaking review of a case.

  2. Eligibility Review

    We determine whether the dispute is eligible for review under the No Surprises Act. Initial eligibility determinations are made based on the application of the law and regulations and evidence and information submitted by the parties.  Once an initial eligibility determination is made in favor of eligibility, the IDRE sends notices for the parties to submit required fees and offers.

  3. Fee, Offer, and Evidence Review

    Our team evaluates all fees, offers, and other submissions from both parties.

  4. Determination

    A decision is issued based on the strongest evidence, in compliance with statutory timelines.

  5. Stakeholder Communication

    EdiPhy Advisors is committed to excellence in communication and has developed a Stakeholder Communication team and process. Communication occurs throughout the dispute and in some cases subsequent to closure of the dispute. EdiPhy strives for clarity in communication and prompt response to stakeholders.

     

IDRE Form​

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Independence, Integrity, and Compliance

As an Independent Dispute Resolution Entity, EdiPhy Advisors operates with strict adherence to conflict-of-interest standards and regulatory obligations. Independence and integrity are foundational to our role in the IDRE process. Parties can rely on EdiPhy Advisors to conduct reviews that are fair, defensible, and compliant.

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