Methodology

How we calculate the filing benchmark.

Every number on this site comes from the CMS Federal IDR Public Use Files. Those files are public. Anyone can download them and reproduce what follows.

← Back to home

Where the data comes from

CMS publishes the outcome of every federal IDR dispute decided under the No Surprises Act. Each quarter's file lists the dispute, the type of service, the offer submitted by the provider side, the offer submitted by the plan side, which offer prevailed, and the email address of the party that filed.

We use the 2025 Q1 through Q4 releases covering out-of-network emergency and non-emergency items and services. We do not add, model, or estimate any field. Nothing is licensed, purchased, or scraped.

What we include

Out of the full file, a claim line is scored only if all of the following hold.

  • The dispute reached a decision. Withdrawn, ineligible, and still-open disputes are excluded, because there is no outcome to measure.
  • The plan offer, the provider offer, and the prevailing offer are all present and greater than zero.
  • The filing party is identifiable by email domain.

That leaves 5,728,139 decided claim lines.

We then score only filers with at least 500 decided lines in the year. Below that, a handful of large disputes swings the average enough to make the number meaningless. The threshold leaves 632 filers, and those 632 account for roughly 90% of all decided volume.

How each metric is defined

All three are dollar-weighted. A $40,000 dispute counts forty times as much as a $1,000 dispute, because that is how it lands in the bank.

Win rate

The share of decided lines where the arbitrator picked the filer's offer. This is the number most IDR vendors report.

win rate = decided lines won ÷ decided lines

Ask

How aggressively the filer priced its offer, relative to what the plan put on the table for the same dispute. An ask of 2.0 means the filer asked for twice the plan's offer.

ask = Σ provider offer ÷ Σ plan offer

Recovery multiple

What the filer actually got paid, relative to what the plan offered. This is the money number. It combines how often you win with how much you win.

recovery multiple = Σ prevailing offer ÷ Σ plan offer

The quartiles on the home page rank the 632 filers by win rate, split them into four equal groups, and report the dollar-weighted recovery multiple of each group.

How filers are grouped

CMS does not publish a clean organization identifier. The one consistent field that identifies who filed is the email address on the submission, so we group by its domain.

This is the sharpest tool in the file and also the bluntest. A domain is stable, it is machine-readable, and it does not depend on how a name was typed. But it identifies whoever pressed submit, not necessarily the practice whose money is at stake.

What the data cannot tell you

We would rather you know these up front.

  • Offers are published as percentages of the QPA, not as dollars. Every ratio here is exact. Absolute dollar amounts are not in the file.
  • The filing domain is often a vendor, not the provider. When a group uses a filing agent, the agent's domain appears. That is useful if you want to see how your vendor performs across its whole book, and misleading if you read it as your practice alone.
  • Entity names in the file do not reconcile. The same organization appears under several spellings, so name matching is unreliable. Domain matching is why we group the way we do.
  • Case mix is not controlled for. Specialty, geography, and service type all move recovery. Two filers with different multiples are not automatically better and worse at the same job.
  • CMS publishes in arrears. A quarter appears months after it closes, and earlier quarters are restated when disputes finish. Numbers shift slightly between releases.

Last refreshed

August 2026, against the CMS release published 15 July 2026. We rerun the full analysis with each new CMS release and restate prior quarters when CMS does.

Questions about the method, or want your own filing record pulled from the same file? sales@recoursehealth.com

We already have your filing record.

Same file, same method, run on your domain. Nothing needed from you.

Get your free filing benchmark