Most IDR contracts are private. One is public: Nutex Health filed its May 2024 agreement with HaloMD as an exhibit to its annual report. It is a useful reference for what to look for in any vendor contract.5
What the filed agreement says
- Fee basis: 20% of the net payment from settlement or arbitration, defined as amounts awarded or settled above the initial allowed amount.
- Fees: the client is responsible for IDRE fees and the CMS administrative fee, paid from an operating account the client owns, under a power of attorney.
- Term: three years, renewing for one-year periods, with the vendor as the client’s sole and exclusive agent for covered disputes.5
In 2026 the parties amended the agreement retroactively to move certain fees to a pay-on-collected basis.6
Why the fee base matters
Providers win most federal disputes; 85% in Q1 2024. Winning is not the same as being paid. A fee on the award is due whether or not the payer pays. A fee on cash collected is due only when the money arrives, which puts the vendor on the same side of the collections problem as you.1
Five questions for any IDR contract
- Is the fee charged on the award, the uplift, or cash collected?
- Who pays the admin and IDRE fees, from whose account, and who absorbs them when a filing is ruled ineligible?
- How long is the term, is it exclusive, and what happens to open disputes if we leave?
- Can we see every claim, deadline and determination ourselves, any day?
- What happens on day 31 when an award has not been paid?
Summaries of public rules and filings. Not legal advice.