Providers' offers were selected in 85% of payment determinations in 2024, according to the CMS federal IDR supplemental background report for 2024. That figure doesn't mean filing more cases is the strategy. It means the No Surprises
Providers' offers were selected in 85% of payment determinations in 2024, according to the CMS federal IDR supplemental background report for 2024. That figure doesn't mean filing more cases is the strategy. It means the No Surprises
In 2024, 53 million prior authorization determinations were made for Medicare Advantage enrollees, according to KFF. That scale changes how you should judge prior authorization services. They're not a clerical shortcut for moving forms. They're a cash
44,238 federal IDR disputes involved out-of-network air ambulance services in 2024, according to the Congressional Research Service. That volume makes air ambulance billing an evidence-management problem, not just a claim-submission problem. A biller needs to know which
You're looking at a month that felt busy in the clinic and thin in the bank account. The schedule was full, the cases were done, but accounts receivable crept up, a payer paid a string of claims
Specialty operators still treat a payment dispute like a one-off appeal. Under the No Surprises Act, volume says otherwise. Federal independent dispute resolution now behaves like a production line for out-of-network cash, and a large share of
You're staring at a statement after an emergency visit. The hospital was in network, the clinician apparently wasn't, and the balance doesn't match anything your plan booklet described. You call billing and someone says you can negotiate.
A hospital stay changes the financial equation for patients. In 2022, 50% of people in the United States who had a hospital stay incurred at least $1,000 in out-of-pocket health-care spending, compared with 19% of people who
The No Surprises Act prohibits balance billing for out-of-network emergency services and certain non-emergency services at in-network facilities, with independent dispute resolution available when providers and insurers can't agree on payment. The federal IDR system recorded 2,559,375
Certified IDR entities issued 1,047,575 payment determinations in 2024, compared with 209,346 in 2023, proving that federal independent dispute resolution is now a primary reimbursement channel rather than a niche exception process. Providers should treat IDR as
Most advice about healthcare revenue integrity starts in the wrong place. It tells specialty practice leaders to improve charge capture, educate coders, and work denials faster. Those activities matter, but they don't explain why a claim that
