While there remain challenges in the Independent Dispute Resolution (IDR) portal, the main one being extensive backlogs, the second half of 2023 proved to be positive for providers. The IDR portal is the arbitration process developed by the government pursuant to the No Surprises Act. The purpose of the portal is to provide a process for settling disputed reimbursement amounts between out of network providers and payers. Since its implementation in 2022, the IDR portal has been plagued with issues. The most recent data released by CMS shows that providers are prevailing, and the very flawed qualifying payment amount (QPA) calculated and presented by payers is not an accurate reflection of true reimbursement rates. In the last 6 months, providers and initiating parties have been awarded their full reimbursement amounts in more than 70% of cases. Additionally, the resulting payment amount in those cases averages more than 170% of the QPA presented by the payers. The process itself remains cumbersome, but the current results are good news for providers, including anesthesiologists. Seven Hills Practice Management will continue to monitor and update on any new development in the IDR process.