In 2025, federally contracted arbitrators helped resolve around 2.5 million billing disputes between doctors and health insurers.

These arbitration firms help run the No Surprises Act, a law Congress passed in 2020 to eliminate the surprise bills that patients received after emergency care from doctors who did not take their insurance.

The law has generally succeeded in protecting consumers. But it has generated millions more disputes than expected and led to large payouts to some doctors.

The arbitration firms, sometimes known as independent dispute resolution entities, are a key part of this process because they decide how much the insurer has to pay doctors in these cases.

The New York Times wants to better understand how these firms work by talking to people there, about how decisions are made, what factors are weighed, and what they’re learning about the offers each side makes. We also welcome perspectives from those who use the arbitration system, like doctors, insurers and employers who run health plans.

We will follow up with you before publishing any part of your submission or your name. If you’d prefer to reach the reporters directly on email or Signal, you can find their contact information here and here.