State IDR · NY

New York out-of-network disputes

Independent dispute resolution, final-offer.

Summary as of October 12, 2026Not legal adviceSource 13
Law
Financial Services Law Article 6 (sections 601 to 608)
Regulator
Department of Financial Services (DFS), with DFS-certified IDR entities
Who it covers

Plans and services in scope

  • Emergency services (section 605) and surprise bills (section 607) under state-regulated plans.
  • Not disputes for care at a participating hospital or ambulatory surgical facility when a participating provider was available, according to DFS guidance.
Timeline
  1. Within 3 years of the plan’s original paymentLast day to submit the dispute to an IDR entity.
  2. Up to 10 business daysOptional negotiation, running alongside the IDR entity’s review.
  3. 30 business days (emergency)IDR entity decides emergency-services disputes.
  4. 45 business days (surprise bills)Decision period for surprise-bill disputes under the statute as amended effective August 26, 2026, counted from receipt of all needed information.
How Revise handles it

The engine separates emergency and surprise-bill disputes, tracks the three-year filing limit and the decision clocks, and keeps each IDR entity’s record.

Fees

The IDR entity’s fee is set under DFS rules. The loser generally pays.

Where federal IDR applies

Self-funded employer plans are outside DFS authority and go to the federal process.

Other states

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Sources

  1. 13New York Financial Services Law Article 6 (sections 601 to 608) and DFS independent dispute resolution entity guidance. Source