State IDR · FL
Florida out-of-network disputes
Statewide Provider and Health Plan Claim Dispute Resolution Program.
Who it covers
Plans and services in scope
- Claim disputes between providers and state-regulated health plans, including emergency services.
- Contracted and non-contracted providers alike.
Timeline
- After the plan’s payment or denialProvider files with the program through AHCA’s contractor.
- ReviewThe resolution organization reviews the claim and recommends a resolution to AHCA.
How Revise handles it
The engine decides program or federal for each Florida claim and watches the 2026 legislation that changes the overlap.
Fees
The program is paid for by the parties that use it. Fees are set in the AHCA contract.
Where federal IDR applies
Florida’s program is a specified state law for the claims it covers, which keeps those claims out of the federal process. Self-funded plans go federal.
Other states
Send us one month of remits.
We’ll show you what you left on the table.
Seven business days. No cost. A line-by-line report of eligible claims you didn’t file, QPAs that don’t add up, and awards you were never paid.
Sources
- 14Florida Statutes s. 408.7057, Statewide Provider and Health Plan Claim Dispute Resolution Program. Source