This document is about the instructions and form for requesting an extension of the Federal independent dispute resolution (IDR) process time periods due to extenuating circumstances. The Federal IDR process allows group health plans, health insurance issuers, Federal Employees Health Benefits (FEHB) carriers, and non-participating providers, facilities, and air ambulance services to determine the out-of-network rate for certain healthcare items and services. The document outlines the specific time periods involved in the IDR process and the criteria for requesting an extension of these time periods in case of extenuating circumstances beyond the control of the parties. The request form must be completed and submitted to the Departments of Health and Human Services, Labor, and the Treasury.