Certified IDR entities and 2026 fees

Fees are per dispute. Single means one line item. Batched means 2 to 25 line items. The tiered fee is added once for every 25 additional lines starting at line 26 (so a 50-line batch pays the batched fee plus one tier).

medlitix is listed by CMS as not accepting new disputes at this time. Dane Street is new for 2026.

Source: CMS list of certified organizations, page last modified August 31, 2026. Confidence: high.

1. Both parties pay the entity fee when the entity is selected. Both also pay the $15 federal admin fee.
2. The entity picks one of the two offers. Whoever’s offer is picked wins.
3. The winner’s entity fee is refunded. The loser’s fee stays with the entity.
4. The admin fee is never refunded.
5. If the entity decides the dispute was not eligible, both fees are typically refunded. To confirm against current CMS guidance.

So the real cost of filing is $15 if you win and $15 plus the entity fee if you lose. Pick disputes you can win.

• When you file, you name a preferred entity. The insurer can agree or object.
• If the two sides don’t agree within the selection window, CMS assigns one at random.
• Starting November 13, 2026, entity selection runs through the IDR Gateway web forms. Standalone forms end January 15, 2027.
• Insurers watch selection deadlines closely and some switch their choice at the last moment, so we track the selection clock on every dispute.

The fee is the easy part. The harder question is how each entity tends to rule for your specialty and your insurer. CMS publishes dispute outcomes in its public use files, and private groups track per-entity results. We’re building our own view from the CMS data and from the disputes we file. We don’t publish win rates by entity until our sample is large enough to be honest. Ask us and we’ll tell you what we see.

Two practical rules:

• Don’t pick on fee alone. A $75 difference in fee is nothing against a $5,000 difference in award.
• Watch the recertification list. An entity that loses certification has its open disputes reassigned and fees refunded, which costs you time.

Certified entities serve five-year terms and must reapply. CMS posts each applicant for public petition. Several entities were posted in October 2026, and insurer and employer groups have asked CMS to pause recertification and tighten standards. Two things could follow: a smaller pool, or new rules on how entities explain decisions. Either one makes selection timing matter more. We’ll update this page as CMS decides.

We propose an entity for each dispute with the reason, your group approves, and we file. We don’t take any payment or referral from any certified entity.