IDRPro runs the entire No Surprises Act Independent Dispute Resolution process for providers — eligibility, open negotiation, filing, QPA rebuttal and award enforcement. We are paid only when you are.
Prevalence and award figures reflect publicly reported CMS Federal IDR outcome data across recent reporting periods and vary by specialty, venue and payer. Not a guarantee of results.
One team owns every claim from eligibility screen to deposited award. Your billing staff keep doing what they do; we handle the disputes.
Eligibility determination, open-negotiation notices, batching strategy, certified IDR entity selection, offer construction and QPA rebuttal — filed on time, every time.
Surprise-billing dispute resolution in every major state venue, including New York, New Jersey, Texas, Florida and California, with venue selection optimized per claim.
Systematic pursuit of underpaid OON claims, including reprocessing requests, payer negotiation and escalation to arbitration where the numbers justify it.
Contract and non-contract underpayment appeals with the documentation and clinical narrative payers require to move a claim off the denial queue.
A free look-back at your denied, underpaid and timed-out OON claims to identify what is still within the dispute window and worth pursuing.
Claim-level dashboards of filings, awards, payer behavior and days-to-payment so your leadership sees exactly what is being recovered and from whom.
We manage every statutory deadline in the process. You provide claim data and clinical records; we do the rest.
We analyze your denied and underpaid OON claims, screen for federal and state eligibility, and quantify recoverable dollars — at no cost.
We initiate the 30-day open-negotiation period, assemble the evidentiary record and build the offer strategy for each batch.
Claims are batched and filed with the appropriate federal or state entity with a full QPA rebuttal, credentialing and complexity narrative.
We track awards through the 30-day payment window and escalate non-payment through CMS complaints and enforcement action where required.
Facility-based and emergency specialties generate the highest IDR volume — and the largest gap between billed charges and QPA.
Our leadership has run out-of-network billing inside provider organizations and taken thousands of claims through federal and state venues. We know which claims win, what evidence moves an arbitrator, and where payers stall.
Most practices lose IDR money for one reason: nobody owns the deadlines. We own every one of them, from the first negotiation notice to the day the award clears.
— IDRPro leadershipRepresentative outcomes by specialty, showing the initial payer payment against the arbitration award.
Payer paid a fraction of the QPA on a complex reconstruction. Filed federally with a surgeon-credential and complexity rebuttal.
Same-payer, same-CPT batching strategy across a quarter of underpaid surgical claims for a five-surgeon group.
Emergency service disputed at the federal level after failed open negotiation. Award reflected acuity and after-hours delivery.
Standing IDR program with monthly batch cadence and payer-specific offer models.
Federal IDR filing with mileage, acuity and base-cost evidence against a QPA-anchored payer offer.
Results shown are illustrative composites based on published Federal IDR outcome patterns and typical specialty economics, not actual client results. Individual outcomes depend on eligibility, venue, payer, documentation and claim mix.
A directional estimate based on your OON volume and current payer payments. We refine it with real claim data in the free review.
Illustrative only. Excludes our contingency fee and assumes awards are collected in full. Actual eligibility, award levels and timing vary by payer, venue and specialty.
Validate with real claimsIndependent Dispute Resolution is the arbitration mechanism created by the No Surprises Act. When an out-of-network provider disagrees with a plan's payment for an eligible emergency or facility-based service, either party can submit the dispute to a certified IDR entity, which selects one of the two offers. Providers have historically prevailed in the large majority of determinations.
On contingency only. There are no retainers, filing charges, administrative fees or software costs. Our fee is a percentage of the incremental amount actually collected above what the payer originally paid.
Eligibility depends on the service type (emergency services, non-emergency services at in-network facilities, and air ambulance), the plan type, the state in which the service was delivered, and completion of the required open-negotiation period within the statutory deadlines. Our free review screens every claim against these criteria.
No. We work alongside your existing billing team, practice management system and clearinghouse. We need claim data and clinical records; the rest of your revenue cycle continues unchanged.
Federal disputes typically resolve within 60–120 days of filing, with payment due 30 days after the determination. State venues vary. We manage all deadlines and pursue enforcement when payers do not pay awards on time.
Yes. Where a state process applies instead of, or in addition to, the federal process, we select the venue that maximizes recovery and file accordingly.
A claims export for your out-of-network encounters (typically the last 12–24 months), remittance data, and access to clinical documentation for the claims we pursue. We execute a business associate agreement before any data is shared.
Send us a few details and we will come back within one business day with next steps and a data request. No obligation.