Out-of-network claims and No Surprises Act disputes, managed end to end
Underpaid out-of-network claims are a deadline problem as much as a coding problem. We're opening this service to a small number of practices first, so we can run each dispute with full attention.
Claim Review for NSA Applicability
We check which underpaid claims fall under No Surprises Act protections, which do not, and which are worth pursuing.
Open Negotiation
We start the open negotiation period on time and document each offer, response and date, because the clock is unforgiving.
Federal IDR Filing
If negotiation fails, we prepare and file the independent dispute resolution request inside the required window and handle the administrative steps.
Offer and Evidence Packages
We assemble the case: the service, the provider's credentials and experience, the payer's qualifying payment amount and comparable payment data.
Deadline Tracking
Every dispute sits on a deadline tracker, with a named owner for each step, so nothing lapses.
Outcome Reporting
You see each dispute, the offers on both sides, the decision and the dollars paid, so you can judge the program on results.
Eligibility screen
We review the claim, the plan type and the payment to confirm the dispute path.
Open negotiation
We send the negotiation notice and pursue a settlement inside the federal open negotiation period.
IDR initiation
If there is no agreement, we file the dispute request inside the window and confirm the certified entity.
Evidence and offer
We submit the offer and the supporting evidence for the arbitrator.
Payment tracking
We track the payment from the payer, follow up on late payments and report the result.
- Facility-based specialties such as anesthesia, emergency medicine, radiology and pathology
- Ambulatory surgery centers with out-of-network exposure
- Practices whose out-of-network payments have dropped under No Surprises Act rules
- Groups that want one owner for every dispute deadline
Timelines above reflect the federal No Surprises Act process and can change. We confirm current requirements for each dispute.
Related reading and services: No Surprises Act billing 2026 · Payer contract negotiation · Revenue Recovery · Anesthesia billing.
Have out-of-network claims that were underpaid?
Send us a few examples. We'll tell you whether they qualify for the federal process and what a dispute would involve.
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