MultiPlan (now Claritev) in Federal IDR Disputes
MultiPlan is named as the non-initiating party in 144,697 disputes. Self-insured plans account for 87% of the profile — the highest self-insured share in the table.
What CMS Reports
| Plan type | Disputes | Share | Which process it points to |
|---|---|---|---|
| Self-funded or partly self-funded employer plan | 125,902 | 87% | Federal — ERISA preempts state regulation |
| Fully insured group plan | 14,634 | 10% | A state process may apply |
| Individual market | 2,484 | 2% | Depends on the state |
| Federal Employees Health Benefits carrier | 91 | 0% | Federal |
| Non-federal government plan (state or local) | 109 | 0% | Depends on the state — not an ERISA plan |
| Church plan | 25 | 0% | Depends on the state — not an ERISA plan |
| No issuer response | 1,452 | 1% | Plan type not established |
| All plan types | 144,697 | 100% |
Source: CMS, Federal IDR Supplemental Tables, Q3 and Q4 2025, Table 9 — “Top 10 Non-Initiating Parties”. “Non-initiating party” is the Departments' own term for the party a dispute is brought against; it carries no finding about conduct, and the counts measure volume of disputes rather than anything else. Note that MultiPlan is a cost-management and repricing vendor that appears in disputes as the plan's representative, not as the insurer. CMS publishes these tables here.
Federal Process or State Process
ERISA preemption directs the 87% self-insured portion to the federal IDR route. The 10% fully insured share is where a state pathway may be available; the 2% individual market and 0% FEHB follow their applicable pathways. Disputes logged without a plan response total 1,452.
Why this decides so much: filing into the wrong process ends the dispute on eligibility rather than on the merits. Of the 1,449,900 disputes closed nationally in the second half of 2025, 271,399 — about 19% — were closed as ineligible, and the non-initiating party challenged eligibility in 574,128 of the 1,372,563 disputes initiated. What eligibility turns on.
Before you file against MultiPlan
- Verify whether MultiPlan is acting as a leasing network or as the actual plan administrator, since the funding type of the underlying plan determines the route
- Confirm the 30-business-day open-negotiation and four-business-day IDR initiation deadlines against the date of the underlying remittance
- For the 1,452 disputes logged without a plan response, compile the eligibility and contract file to support the funding determination
What the Federal Medians Say Your Claims Are Worth
Volume tells you who is in the room. What a decided dispute is worth depends on the service and the size of the claim, not on the payer: CMS reports the median prevailing offer at 5.22× the plan's own qualifying payment amount on claims under $100, falling to 1.69× at $10,000 and above, and it varies by specialty from 2.00× to 25.85×.
The medians for your specialty · The full federal dataset · What this costs