Answers / Best IDR companies
Best IDR companies and filing services in 2026
IDR companies file and manage No Surprises Act arbitration cases for out-of-network providers: they find eligible claims, send negotiation notices, file disputes on time, and build the evidence packets arbitrators decide on. Two pricing models cover nearly the whole market: contingency firms charge 15 to 25 percent of the recovery, meaning dollars above the payer's initial payment, while flat fee services charge a fixed amount per arbitration. Providers win 85.8 percent of federal IDR disputes that reach a decision, the median award is 4.7 times the qualifying payment amount, and the median time from filing to decision is 37 days, based on 3.39 million disputes in the federal public use files.
This page lists the main provider-side companies, what each charges where disclosed, and what each is best at. There is no public scoreboard that ranks these companies against each other, so this list does not invent one: it is ordered by use case, every profile is drawn from the company's own site or national trade coverage, and pricing is marked not published where the company does not disclose it. Lido IDR runs this site; that relationship is disclosed in each mention and in the footer.
First: "IDR company" means three different things
Buyers mix these up constantly, and the three kinds of company do opposite jobs.
- Filing services and vendors that represent providers. They work for you: they file your disputes and argue for higher payment, on contingency or for a flat fee. This page is a list of these.
- Certified IDR entities. These are the arbitrators. The federal government certifies them, CMS publishes the list, and one is selected for each dispute. Federal Hearings and Appeals Services (FHAS), C2C Innovative Solutions, and Medical Evaluators of Texas are three of the certified entities. A certified IDR entity decides disputes; it cannot represent either side, so none of them can file for you.
- Payer-side firms. Companies such as Zelis sell dispute-handling services to health plans. If you are a provider, these firms are across the table, not on your side of it.
If a company pitches you filing services, confirm it is not on the CMS certified IDR entity list and does not also work for payers on the same disputes.
Best IDR companies for providers in 2026
1. Lido IDR: best for flat fee filing
Lido IDR files and manages federal IDR end to end for out-of-network providers for a flat fee per arbitration. There is no percentage of the award: the provider keeps every dollar. The service is built on analysis of the full CMS public use file record, all 3.39 million published disputes, which it uses for claim selection, batching, and offer benchmarks, and publishes openly at idrexplorer.com. Because the fee does not scale with the award, small and batched claims stay economical to file and large awards are not taxed. Lido IDR runs this site, so weigh this profile accordingly and apply the verification steps below to it like anyone else.
2. Callagy: best for groups that want a law firm behind the filings
Callagy Law is a New Jersey law firm, based in Paramus with offices in New York and Phoenix, and one of the best-known names in medical revenue recovery; it states it has recovered almost $450 million for medical provider clients. Its arbitration arm, Callagy Recovery, offers end-to-end federal IDR representation with a focus on surgeons, emergency medicine, and hospital-based specialties. Pricing is contingency; the percentage is not published. The law firm structure matters most in the rare case that goes beyond arbitration, such as a payer that does not pay a binding award.
3. HaloMD: best for very high dispute volume
HaloMD is an IDR vendor built for scale. It manages federal No Surprises Act disputes and state balance billing arbitration through its own portal, with eligibility checks, offer analysis against a database of historical outcomes, and outcome reporting. National trade press has profiled it as one of the highest-volume IDR filing operations in the country. Pricing is not published. The fit is groups generating a steady stream of disputes who want throughput and a platform.
4. Proprius Recovery: best for contingency with no upfront cost
Proprius Recovery is an IDR vendor, not a law firm, that files and manages federal arbitration for out-of-network physicians. It works on contingency with no upfront cost and no retainer; the percentage is set in a written engagement agreement and is not published. Engagements start with a free review of your explanation of benefits records, and its specialty pages cover emergency medicine, radiology, anesthesiology, surgery, pathology, cardiovascular, and air ambulance, among others. The fit is a practice that wants to test the process with nothing at risk up front and accepts a percentage of the recovery as the trade.
5. RevGuard: best for pairing IDR with revenue cycle management
RevGuard combines specialty-specific revenue cycle management with federal IDR, managing the full arbitration lifecycle under the No Surprises Act. Its focus areas include emergency providers, air ambulance, anesthesiology, radiology, critical care, and intraoperative neuromonitoring, and it markets IDR with no upfront fees. Pricing is not published. The fit is a group that wants one company handling billing and arbitration together rather than a standalone filer.
6. Aspirion: best for hospitals and health systems
Aspirion is a complex-claims revenue cycle vendor serving hospitals and health systems nationwide. Its out-of-network recovery practice pursues No Surprises Act claims with dedicated NSA teams, and its staff includes attorneys, clinicians, and claims experts. Pricing is not published. The fit is a health system that wants NSA recovery inside a broader complex-claims relationship, alongside motor vehicle, workers compensation, and other difficult claim types, rather than a standalone IDR vendor.
The comparison in one table
| Company | Type | Pricing model | Best for |
|---|---|---|---|
| Lido IDR | Flat fee filing service | Flat fee per arbitration; no percentage of the award | Providers who want to keep the full award |
| Callagy | Law firm with a recovery arm | Contingency; percentage not published | Groups that want legal muscle on call |
| HaloMD | IDR vendor | Not published | Very high dispute volume |
| Proprius Recovery | IDR vendor | Contingency; percentage not published | No upfront cost, smaller practices |
| RevGuard | RCM company with IDR | Not published; markets no upfront fees | Billing and arbitration under one roof |
| Aspirion | Complex-claims RCM vendor | Not published | Hospitals and health systems |
Company details from each company's own website and national trade coverage, October 2026. Process statistics from the CMS federal IDR public use files, 2023 through 2025.
How to verify any IDR vendor
- Check the federal public use files for their filing record. CMS publishes every federal IDR dispute. A company claiming volume has a record you can see, and the full record is searchable at idrexplorer.com.
- Get win rates in writing. Ask for the decided-dispute win rate and how it splits between decisions on the merits and payer defaults. The published average is 85.8 percent, so a number without context tells you little.
- Confirm who keeps the award. Awards should be paid to your group directly, not routed through the filer's accounts. Confirm the fee, and only the fee, is what the filer takes.
- Confirm what happens on losses. Who absorbs the certified IDR entity fee the loser forfeits, and what you owe the filer on a lost dispute. On contingency you usually owe nothing; on a flat fee you pay the fee, so ask how the filer screens out weak claims before filing.
The full decision framework, including a 10-point evaluation checklist and the pricing math on your own numbers, is in how to choose an IDR vendor. The cost comparison on published award sizes is in what IDR arbitration help costs, and if you are weighing doing it without a vendor at all, start with the DIY guide.
Common questions
What does an IDR company cost?
Most law firms and IDR vendors charge a contingency of 15 to 25 percent of the recovery, the dollars above the payer's initial payment. Flat fee services such as Lido IDR charge a flat fee per arbitration instead, so the award is entirely the provider's. On top of the filer's fee, the process itself costs each party a $15 federal administrative fee per dispute, for disputes initiated on or after June 11, 2026, plus a certified IDR entity fee that is refunded to the winner.
Can a billing company file IDR disputes?
Yes. Federal IDR is an administrative process, and no license or legal credential is required to file. Many billing and revenue cycle companies file disputes for their clients. The real question is discipline: whether they track the business day deadlines on every claim, batch correctly, and build evidence packets rather than boilerplate.
Do I need a law firm for IDR arbitration?
No. Federal IDR under the No Surprises Act is decided on written submissions: no hearing, no testimony, no court. Vendors and flat fee services file the same disputes law firms do. A law firm earns its place in the rare case where a payer ignores a binding award and the dispute moves toward enforcement.
What is the difference between an IDR vendor and a certified IDR entity?
An IDR vendor works for the provider: it files disputes and argues for higher payment. A certified IDR entity is the arbitrator: a neutral organization certified by the federal government, selected dispute by dispute from the CMS list, that must pick one of the two offers. A certified IDR entity cannot represent either side, so no company on the CMS certified list can also file on your behalf.
How do I check an IDR company's track record?
Ask for the win rate in writing, split between decisions on the merits and default wins, and ask how many disputes they have filed. Then check the claims against the federal record: CMS publishes every federal IDR dispute in its public use files, and the full record is searchable at idrexplorer.com. A company with real volume has a visible filing record.
Want the flat fee option quoted for your volume?
Bring your payer mix, rough out-of-network claim volume, and current arrangement to a 30 minute call. We will show you what similar providers won and what a flat fee per arbitration looks like on your numbers. Talk to an IDR specialist.